scholarly journals Die gemeenskapsverpleegkundige in perspektief

Curationis ◽  
1982 ◽  
Vol 5 (3) ◽  
Author(s):  
W.C. Grobbelaar
Keyword(s):  
Nursing Education ◽  
Middle Ages ◽  
Industrial Revolution ◽  
Community Nursing ◽  
Care Needs ◽  
Social Reforms ◽  
Nursing Services ◽  
Centered Care ◽  
Nursing Courses ◽  
Basic Course

Community nursing originated in the care given to families, mostly by the women, in primitive societies. The Christian religion had a marked influence on the development of community care with the deaconnesses being regarded as the first visiting nurses. Throughout the middle ages there were nursing orders who worked in the community but social reforms after the industrial revolution led to the emergence of secular district nursing services. The services rendered however tended to become specialised and thus fragmented. Community nursing today involves comprehensive family centered care to individuals and groups in the community by professionally qualified nurses. They work independently and are accountable for their own actions. The nature of the service rendered depends on the community being served. The population profile, disease profile and health care needs differ vastly between highly developed and developing communities. However, irrespective of the type of community being served the community nurse is a co-ordinator in the health team and must render a comprehensive and family-centred health service. Basic nursing education alone does not prepare the nurse adequately for the comprehensive community nursing task. It is suggested that community nursing for registration should be an option in the integrated basic nursing courses. Provision must be made for a program for registration for those who did not include community nursing in their basic course, and for advanced formal programs and informal continuing education programs in community nursing.

Servicing the Senior Swallow: A Family-Centered Private Practice Model of Service Delivery

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Yvette M. McCoy
Keyword(s):  
Older Adults ◽  
Medical Model ◽  
Recovery Process ◽  
Swallowing Disorders ◽  
Current Evidence ◽  
Care Needs ◽  
Skilled Nursing ◽  
Person Centered Care ◽  
Centered Care ◽  
Traditional Medical Model

Purpose Person-centered care shifts the focus of treatment away from the traditional medical model and moves toward personal choice and autonomy for people receiving health services. Older adults remain a priority for person-centered care because they are more likely to have complex care needs than younger individuals. Even more specifically, the assessment and treatment of swallowing disorders are often thought of in terms of setting-specific (i.e., acute care, skilled nursing, home health, etc.), but the management of dysphagia in older adults should be considered as a continuum of care from the intensive care unit to the outpatient multidisciplinary clinic. In order to establish a framework for the management of swallowing in older adults, clinicians must work collaboratively with a multidisciplinary team using current evidence to guide clinical practice. Private practitioners must think critically not only about the interplay between the components of the evidence-based practice treatment triad but also about the broader impact of dysphagia on caregivers and families. The physical health and quality of life of both the caregiver and the person receiving care are interdependent. Conclusion Effective treatment includes consideration of not only the patient but also others, as caregivers play an important role in the recovery process of the patient with swallowing disorders.

The European Guilds

2019 ◽  
Author(s):  
Sheilagh Ogilvie
Keyword(s):  
Middle Ages ◽  
Common Good ◽  
Industrial Revolution ◽  
Dark Side ◽  
Market Failures ◽  
Women Migrants ◽  
Work Skills ◽  
The Common ◽  
Economic Reasoning ◽  
European Economies

Guilds ruled many crafts and trades from the Middle Ages to the Industrial Revolution, and have always attracted debate and controversy. They were sometimes viewed as efficient institutions that guaranteed quality and skills. But they also excluded competitors, manipulated markets, and blocked innovations. Did the benefits of guilds outweigh their costs? Analyzing thousands of guilds that dominated European economies from 1000 to 1880, this book uses vivid examples and clear economic reasoning to answer that question. The book features the voices of honourable guild masters, underpaid journeymen, exploited apprentices, shady officials, and outraged customers, and follows the stories of the “vile encroachers”—women, migrants, Jews, gypsies, bastards, and many others—desperate to work but hunted down by the guilds as illicit competitors. It investigates the benefits of guilds but also shines a light on their dark side. Guilds sometimes provided important services, but they also manipulated markets to profit their members. They regulated quality but prevented poor consumers from buying goods cheaply. They fostered work skills but denied apprenticeships to outsiders. They transmitted useful techniques but blocked innovations that posed a threat. Guilds existed widely not because they corrected market failures or served the common good, but because they benefited two powerful groups—guild members and political elites. The book shows how privileged institutions and exclusive networks shape the wider economy—for good or ill.

Institutional developments, standards and river quality: a UK history and some lessons for industrialising countries

1996 ◽  
Vol 33 (3) ◽  
pp. 211-222 ◽  
Author(s):  
D. W. M. Johnstone ◽  
N. J. Horan
Keyword(s):  
Middle Ages ◽  
Aquatic Environment ◽  
Industrial Revolution ◽  
Integrated Management ◽  
Sewage Treatment ◽  
Lessons Learned ◽  
Process Manufacturing ◽  
Treatment And Disposal ◽  
The Uk ◽  
Developed World

From the middle ages until the early part of the nineteenth century the streets of European cities were foul with excrement and filth to the extent that aristocrats often held a clove-studded orange to their nostrils in order to tolerate the atmosphere. The introduction in about 1800 of water-carriage systems of sewage disposal merely transferred the filth from the streets to the rivers. The problem was intensified in Britain by the coming of the Industrial Revolution and establishment of factories on the banks of the rivers where water was freely available for power, process manufacturing and the disposal of effluents. As a consequence the quality of most rivers deteriorated to the extent that they were unable to support fish life and in many cases were little more than open sewers. This was followed by a period of slow recovery, such that today most of these rivers have been cleaned with many having good fish stocks and some even supporting salmon. This recovery has not been easy nor has it been cheap. It has been based on the application of good engineering supported by the passing and enforcement of necessary legislation and the development of suitable institutional capacity to finance, design, construct, maintain and operate the required sewerage and sewage treatment systems. Such institutional and technical systems not only include the disposal of domestic sewage but also provisions for the treatment and disposal of industrial wastewaters and for the integrated management of river systems. Over the years a number of institutional arrangements and models have been tried, some successful other less so. Although there is no universally applicable approach to improving the aquatic environment, many of the experiences encountered by the so-called developed world can be learned by developing nations currently attempting to rectify their own aquatic pollution problems. Some of these lessons have already been discussed by the authors including some dangers of copying standards from the developed world. The objective of this paper is to trace the steps taken over many years in the UK to develop methods and systems to protect and preserve the aquatic environment and from the lessons learned to highlight what is considered to be an appropriate and sustainable approach for industrialising nations. Such an approach involves setting of realistic and attainable standards, providing appropriate and affordable treatment to meet these standards, establishment of the necessary regulatory framework to ensure enforcement of the standards and provision of the necessary financial capabilities to guarantee successful and continued operation of treatment facilities.

scholarly journals Registered nurses’ role experiences of caring for older stroke patients: a qualitative study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Wei Cheng ◽  
Jiong Tu ◽  
Xiaoyan Shen
Keyword(s):  
Nursing Education ◽  
Older People ◽  
Registered Nurses ◽  
Elderly Care ◽  
The Elderly ◽  
Working Environment ◽  
Structured Interviews ◽  
Stroke Patients ◽  
Care Needs ◽  
Nursing Clinical Practice

Abstract Background With China’s population ageing rapidly, stroke is becoming one of the major public health problems. Nurses are indispensable for caring for older patients with acute and convalescent stroke, and their working experiences are directly linked to the quality of care provided. The study aims to investigate registered nurses’ experiences of caring for older stroke patients. Methods A qualitative descriptive design was adopted. Data were collected via semi-structured interviews with 26 registered nurses about their lived experiences of caring for older stroke patients. Thematic analysis was used to analyze the data. Results Two main themes were identified. First, the nurses identified an obvious gap between their ideal role in elderly care and their actual practice. The unsatisfactory reality was linked to the practical difficulties they encountered in their working environment. Second, the nurses expressed conflicting feelings about caring for older stroke patients, displaying a sense of accomplishment, indifference, annoyance, and sympathy. Caring for older stroke patients also affects nurses psychologically and physically. The nurses were clear about their own roles and tried their best to meet the elderly people’s needs, yet they lack time and knowledge about caring for older stroke patients. The factors influencing their working experiences extend beyond the personal domain and are linked to the wider working environment. Conclusions Sustaining the nursing workforce and improving their working experiences are essential to meet the care needs of older people. Understanding nurses’ lived working experiences is the first step. At the individual level, nurse mangers should promote empathy, relieve anxiety about aging, and improve the job satisfaction and morale of nurses. At the institutional level, policymakers should make efforts to improve the nursing clinical practice environment, increase the geriatric nursing education and training, achieve a proper skill mix of the health workforce, and overall attract, prepare and sustain nurses regarding caring for older people in a rapidly aging society.

COMMUNITY NURSING SERVICES AS PERCEIVED BY POSTHOSPITALIZED PATIENTS

1970 ◽  
Vol 19 (3) ◽  
pp. 279
Author(s):  
BERGMAN REBECCA ◽  
HELL MAN GERDA
Keyword(s):  
Community Nursing ◽  
Nursing Services

Community Nursing: The Challenge of Nursing Education

1946 ◽  
Vol 46 (12) ◽  
pp. 830
Author(s):  
Elín L. Anderson ◽  
Elin L. Anderson
Keyword(s):  
Nursing Education ◽  
Community Nursing

scholarly journals Maternity Care Preferences for Future Pregnancies Among United States Childbearers: The Impacts of COVID-19

2021 ◽  
Vol 6 ◽  
Author(s):  
Theresa E. Gildner ◽  
Zaneta M. Thayer
Keyword(s):  
United States ◽  
Maternity Care ◽  
Community Care ◽  
Insurance Coverage ◽  
The United States ◽  
Care Needs ◽  
Perceived Safety ◽  
Predominately White ◽  
Centered Care ◽  
Future Care

The COVID-19 pandemic has impacted maternity care decisions, including plans to change providers or delivery location due to pandemic-related restrictions and fears. A relatively unexplored question, however, is how the pandemic may shape future maternity care preferences post-pandemic. Here, we use data collected from an online convenience survey of 980 women living in the United States to evaluate how and why the pandemic has affected women’s future care preferences. We hypothesize that while the majority of women will express a continued interest in hospital birth and OB/GYN care due to perceived safety of medicalized birth, a subset of women will express a new interest in out-of-hospital or “community” care in future pregnancies. However, factors such as local provider and facility availability, insurance coverage, and out-of-pocket cost could limit access to such future preferred care options. Among our predominately white, educated, and high-income sample, a total of 58 participants (5.9% of the sample) reported a novel preference for community care during future pregnancies. While the pandemic prompted the exploration of non-hospital options, the reasons women preferred community care were mostly consistent with factors described in pre-pandemic studies, (e.g. a preference for a natural birth model and a desire for more person-centered care). However, a relatively high percentage (34.5%) of participants with novel preference for community care indicated that they expected limitations in their ability to access these services. These findings highlight how the pandemic has potentially influenced maternity care preferences, with implications for how providers and policy makers should anticipate and respond to future care needs.

scholarly journals Using an Interactive App for Symptom Reporting and Management Following Pancreatic Cancer Surgery to Facilitate Person-Centered Care: Descriptive Study

10.2196/17855 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e17855 ◽  
Author(s):  
Tina Gustavell ◽  
Kay Sundberg ◽  
Ann Langius-Eklöf
Keyword(s):  
Health Care ◽  
Pancreatic Cancer ◽  
Self Care ◽  
Symptom Burden ◽  
Symptom Reporting ◽  
Activity Levels ◽  
Care Needs ◽  
Person Centered Care ◽  
Centered Care ◽  
Care Activity

Background Pancreatic and periampullary cancers are rare but have high mortality rates. The only hope for cure is surgical removal of the tumor. Following pancreatic surgery, the patients have a great deal of responsibility for managing their symptoms. Patients report a lack of sufficient knowledge of self-care and unmet supportive care needs. This necessitates a health care system responsive to these needs and health care professionals who pay close attention to symptoms. Person-centered care is widely encouraged and means a shift from a model in which the patient is the passive object of care to a model involving the patient as an active participant in their own care. To address the challenges in care following pancreatic cancer surgery, an interactive app (Interaktor) was developed in which patients regularly report symptoms and receive support for self-care. The app has been shown to reduce patients’ symptom burden and to increase their self-care activity levels following pancreaticoduodenectomy due to cancer. Objective The aim of the study was to describe how patients used the Interaktor app following pancreaticoduodenectomy due to cancer and their experience with doing so. Methods A total of 115 patients were invited to use Interaktor for 6 months following pancreaticoduodenectomy. Of those, 35 declined, 8 dropped out, and 46 did not meet the inclusion criteria after surgery, leaving 26 patients for inclusion in the analysis. The patients were instructed to report symptoms daily through the app for up to 6 months following surgery. In case of alerting symptoms, they were contacted by their nurse. Data on reported symptoms, alerts, and viewed self-care advice were logged and analyzed with descriptive statistics. Also, the patients were interviewed about their experiences, and the data were analyzed using thematic analysis. Results The patients’ median adherence to symptom reporting was 82%. Fatigue and pain were the most reported symptoms. Alerting symptoms were reported by 24 patients, and the most common alert was fever. There were variations in how many times the patients viewed the self-care advice (range 3-181 times). The most commonly viewed advice concerned pancreatic enzyme supplements. Through the interviews, the overarching theme was “Being seen as a person,” with the following 3 sub-themes: “Getting your voice heard,” “Having access to an extended arm of health care,” and “Learning about own health.” Conclusions Interaktor proved to be well accepted. It made patients feel reassured at home and offered support for self-care. The app facilitated person-centered care by its multiple features targeting individual supportive care needs and enabled participation in their own care. This supports our recent studies showing that patients using the app had less symptom burden and higher self-care activity levels than patients receiving only standard care.

scholarly journals MENTAL HEALTH NURSING EDUCATION IN BRAZIL: PERSPECTIVES FOR PRIMARY HEALTH CARE

2020 ◽  
Vol 29 ◽  
Author(s):  
Maria do Perpétuo Socorro de Sousa Nóbrega ◽  
Cinthia Mariotto Martins Venzel ◽  
Ellen Santos de Sales ◽  
Alessandro Coldibelli Próspero
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Nursing Education ◽  
Mental Health Policy ◽  
Mental Health Nursing ◽  
Undergraduate Nursing ◽  
Primary Health ◽  
Primary Care Education ◽  
Nursing Courses

ABSTRACT Objective: To analyze the limitations, strategies, importance and obstacles in mental health education in undergraduate nursing, focused on the role of nurses in Primary Health Care. Method: An exploratory descriptive study conducted with 103 professors in the mental health area of Bachelor/Postgraduate nursing courses from 89 public Higher Education Institutions in the five regions of Brazil. Results: Only 23.3% (24) of the professors teach mental health classes only in primary health care. Of the sample, the limitations to teaching in primary care education are few class hours (46.6%), faculty to expand teaching beyond specialty settings (38.8%), and prioritization of other scenarios (48.5%). When teaching, the strategies used are home visits (43.7%), educational actions (34.0%) and active search for mental health cases (29.1%). The professors consider them important to support mental health actions (58.3%); and the barriers are the lack of articulation between the Collective Health and Health disciplines to conduct teaching (87.5%). Conclusion: It is suggested that the institutions, courses and professors make the commitment and focus efforts to overcome the gaps, which hinder the nurse’s education process regarding primary knowledge in mental health, so that they can offer care to patients in psychological distress in the context of the community, as well as strengthen national mental health policy.

scholarly journals Building a Digital Bridge to Support Patient-Centered Care Transitions From Hospital to Home for Older Adults With Complex Care Needs: Protocol for a Co-Design, Implementation, and Evaluation Study (Preprint)

2020 ◽  
Author(s):  
Carolyn Steele Gray ◽  
Terence Tang ◽  
Alana Armas ◽  
Mira Backo-Shannon ◽  
Sarah Harvey ◽  
...  
Keyword(s):  
Older Adults ◽  
Phase 1 ◽  
Care Transitions ◽  
Self Management ◽  
Complex Care ◽  
Phase 2 ◽  
Care Needs ◽  
Centered Care ◽  
Hospital To Home ◽  
Complex Care Needs

BACKGROUND Older adults with multimorbidity and complex care needs (CCN) are among those most likely to experience frequent care transitions between settings, particularly from hospital to home. Transition periods mark vulnerable moments in care for individuals with CCN. Poor communication and incomplete information transfer between clinicians and organizations involved in the transition from hospital to home can impede access to needed support and resources. Establishing digitally supported communication that enables person-centered care and supported self-management may offer significant advantages as we support older adults with CCN transitioning from hospital to home. OBJECTIVE This protocol outlines the plan for the development, implementation, and evaluation of a Digital Bridge co-designed to support person-centered health care transitions for older adults with CCN. The Digital Bridge builds on the foundation of two validated technologies: Care Connector, designed to improve interprofessional communication in hospital, and the electronic Patient-Reported Outcomes (ePRO) tool, designed to support goal-oriented care planning and self-management in primary care settings. This project poses three overarching research questions that focus on adapting the technology to local contexts, evaluating the impact of the Digital Bridge in relation to the quadruple aim, and exploring the potential to scale and spread the technology. METHODS The study includes two phases: workflow co-design (phase 1), followed by implementation and evaluation (phase 2). Phase 1 will include iterative co-design working groups with patients, caregivers, hospital providers, and primary care providers to develop a transition workflow that will leverage the use of Care Connector and ePRO to support communication through the transition process. Phase 2 will include implementation and evaluation of the Digital Bridge within two hospital systems in Ontario in acute and rehab settings (600 patients: 300 baseline and 300 implementation). The primary outcome measure for this study is the Care Transitions Measure–3 to assess transition quality. An embedded ethnography will be included to capture context and process data to inform the implementation assessment and development of a scale and spread strategy. An Integrated Knowledge Translation approach is taken to inform the study. An advisory group will be established to provide insight and feedback regarding the project design and implementation, leading the development of the project knowledge translation strategy and associated outputs. RESULTS This project is underway and expected to be complete by Spring 2024. CONCLUSIONS Given the real-world implementation of Digital Bridge, practice changes in the research sites and variable adherence to the implementation protocols are likely. Capturing and understanding these considerations through a mixed-methods approach will help identify the range of factors that may influence study results. Should a favorable evaluation suggest wide adoption of the proposed intervention, this project could lead to positive impact at patient, clinician, organizational, and health system levels. CLINICALTRIAL ClinicalTrials.gov NCT04287192; https://clinicaltrials.gov/ct2/show/NCT04287192 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/20220

Sign in / Sign up

Export Citation Format

Share Document