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Holistic Assessment (holistic + assessment)
Selected AbstractsRevisiting the evaluation of clinical practiceINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 2 2007Matthew J Leach PhD BN(Hons) ND RN MATMS The evaluation of patient care is an ongoing process that is aimed at improving clinical outcomes, as well as advancing clinical practice. However, a number of elements need to be taken into account when evaluating clinical practice, including social, structural and process factors. Consideration of these factors, together with comprehensive and holistic assessment, clinical expertise, reflective thinking, and valid and reliable instrumentation, will allow practitioners to better evaluate clinical care, and in effect, improve client outcomes. [source] Nurses' experiences with telephone triage and advice: a meta-ethnographyJOURNAL OF ADVANCED NURSING, Issue 3 2010Rebecca J. Purc-Stephenson purc-stephenson r.j. & thrasher c. (2010) Nurses' experiences with telephone triage and advice: a meta-ethnography. Journal of Advanced Nursing66(3), 482,494. Abstract Aims., This study is a meta-ethnography of nurses' experiences with telephone triage and advice and factors that facilitate or impede their decision-making process. Background., Telephone triage and advice services are a rapidly expanding development in health care. Unlike traditional forms of nursing practice, telenurses offer triage recommendations and advice to the general public without visual cues. Data sources., Published qualitative research on telephone triage and advice were sought from interdisciplinary research databases (1980,2008) and bibliographical reviews of retrieved studies. Review methods., Our systematic search identified 16 relevant studies. Two researchers independently reviewed, critically appraised, and extracted key themes and concepts from each study. We followed techniques of meta-ethnography to synthesize the findings, using both reciprocal and refutational translation to compare similar or contradictory findings, and a line-of-arguments synthesis. Results., We identified five major themes that highlight common issues and concerns experienced by telenurses: gaining and maintaining skills, autonomy, new work environment, holistic assessment, and stress and pressure. A line-of-arguments synthesis produced a three-stage model that describes the decision-making process used by telenurses and highlights how assessments largely depend on the ability to ,build a picture' of the patient and the presenting health issue. Conclusion., Telenurses experience a range of common concerns and issues which either impede or facilitate the decision-making process. Although ,building a picture' of the patient is key to making assessments over the telephone, final triage decisions are influenced by balancing the conflicting demands of being both carer and gatekeeper to limited healthcare services. [source] The meaning of self-care for people with chronic illnessJOURNAL OF NURSING AND HEALTHCARE OF CHRONIC ILLNE SS: AN INTERNATIONAL INTERDISCIPLINARY JOURNAL, Issue 3 2010Debbie Kralik RN kralik d, price k & telford k (2010) Journal of Nursing and Healthcare of Chronic Illness2, 197,204 The meaning of self-care for people with chronic illness Aim., To reveal the meaning of self-care as described by men and women living with chronic conditions. Background., Chronic illness self-care and self-management are terms that have been used interchangeably in the literature. Self-care in the context of chronic illness has received some research attention, but remains an under-explored concept. Methods., Conversation data were gathered using longitudinal email groups facilitated by the first author over a 21-month period between 2003,2005, with 42 men and women living with chronic illness. Results., Self-care is a process of adaptation in response to learning about oneself and about ways to live well with illness. Developing capacity to self care impacted significantly on the way participants experienced illness, their view of themselves and of their future. Conclusions., People living with chronic illness describe the process of self-care as transformational in terms of feelings about their selves and reclaiming a sense of order. It enables them to move forward with a sense of the future. The primary health care principle of holistic assessment, taking account of the wider context of people's lives, is of heightened importance when educating about self-care. Relevance to clinical practice., Health care workers can assist people by acknowledging that chronic illness self-care is a process that gradually evolves and is borne out of listening to the person's priorities and finding ways for strategies to fit harmoniously alongside those priorities. [source] A nurse-led rheumatology clinic's impact on empowering patients with rheumatoid arthritis: A qualitative studyNURSING & HEALTH SCIENCES, Issue 3 2006S. Barbro Arvidsson rnt Abstract, The aim of this study was to describe a nurse-led rheumatology clinic's impact on empowering patients with rheumatoid arthritis (RA). Rheumatoid arthritis is a chronic, inflammatory disease that attacks many joints, causing considerable functional restrictions for patients. Consequently, these patients are dependent on a wide variety of health-care services. A descriptive, qualitative design inspired by phenomenography was chosen. The conceptions were collected through interviews with 16 strategically selected patients with RA. Three descriptive categories comprising eight conceptions emerged: teaching (gaining insight and receiving information), regular review (receiving security, realizing regularity, and achieving accessibility), and attention (getting a holistic assessment, receiving coordinated care, and getting sufficient time). A nurse-led rheumatology clinic can be a source for empowering patients with RA to adopt new stances to alternative actions and achieve a higher level of faith in their own abilities. [source] | ||||||||||