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Innovative Models (innovative + models)

Distribution by Scientific Domains
Medical Sciences80%

Selected Abstracts

Satellite babies in transnational families: A study of parents' decision to separate from their infants,

INFANT MENTAL HEALTH JOURNAL, Issue 3 2009
Yvonne Bohr
This study examines a practice which is characteristic of an era of intensifying globalization: As part of a transnational lifestyle, an increasing number of immigrants to North America send infants thousands of miles back to their country of origin to be raised by members of their extended families,a culturally sanctioned tradition. After several years of separation, the children return to the biological parents to attend school in the adopted country, a custom which, according to Western mental health models, could have significant sequelae for attachment relationships and other facets of development. This practice is particularly prevalent among immigrants from the People's Republic of China, but a modified version of it can be found in other groups as well. The work described here is the first phase of a longitudinal project that explores the advantages and potential repercussions, for both infants and parents, of a transnational lifestyle. The current study reviews the decision-making process of a group of Chinese Canadian immigrant parents who are considering a separation from their infants. Preliminary findings show that the expected concerns about disrupting attachment relationships are embedded in more salient considerations of economic need and cultural perspective. These exploratory data exemplify an emergent field of culture-focused research and practice in infant mental health, and support the call for innovative models to situate infant developmental pathways in global and transcultural contexts. [source]

Depressive symptoms and suicidal ideation among older adults receiving home delivered meals

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2008
Jo Anne Sirey
Abstract Objective Homebound older adults may be vulnerable to the deleterious impact of untreated depression. Yet because these elders are difficult to reach, there is little data on the rates of depressive symptoms and suicidal ideation among this group. The objective of this study is to document the rates of depression and correlates among a population of homebound elders. Methods Using a community based participatory research partnership, we implemented a routine screening for depressive symptoms and suicidal ideation among older recipients of Westchester County's home meal program. Older adults enrolled in the home delivered meal program were administered the Physician Health Questionnaire,9 (PHQ-9), and questions to assess pain, falls, alcohol abuse and perceived emotional distress. Results In our sample of 403 meal recipients, 12.2% of older adults reported clinically significant depression (PHQ-9,>,9) and 13.4% reported suicidal thoughts. One-third of recipients with significant depressive symptoms were currently taking an antidepressant. Almost one-third of older adults who endorsed suicide ideation did not report clinically significant depressive symptoms. Among men, suicidal thoughts were associated with chronic pain and greater depression severity, whereas pain was not a predictor of suicidal thoughts among women. Conclusion More than one in nine elders suffer from depression; most are untreated with one-third undertreated. Through partnerships between public agencies that provide age related services and academic investigators there is an opportunity for improved detection of unmet mental health needs. Future research should explore innovative models to improve access to mental health services once unmet need is detected. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Patient Response to the Fast-Track Experience

INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003
Jane Flanagan
PURPOSE To describe patients' functional health, symptom distress, and recovery at home across a fasttrack perioperative experience. METHODS A nonexperimental, descriptive, correlational design using pre/post test measures and openended questions captured the fast-tracking experience. A convenience sample included 77 patients entering the same-day surgery unit to undergo arthroscopy with general anesthesia and planned fast-track recovery. In the preadmission test area, patients were asked by a nurse to participate in the study. If they agreed and met selection criteria, a nurse completed a demographic sheet, the Foster and Jones Functional Health Pattern Assessment Screeing Tool (FHPAST), and the Symptom Distress Scale (SDS). On the evening of surgery, a nurse called the patient to review the SDS to be completed by phone. At 72 hours after surgery, the FHPAST, the SDS, and a 72-hour open-ended questionnaire were administered to understand the patient experience of fast-tracking. FINDINGS At 12 hours nurses reported patients were "euphoric" and it was difficult to imagine pain or other symptoms. Some patients complained of nausea and fatigue. Most patients had family present. At 72 hours patients described unmet expectations, fatigue, immobility, ineffective pain management, sleep disturbance, and nausea. Interventions included teaching, coaching, and reassurance. Some patients continued to have nursing problems at 72 hours and benefited from a telephone follow-up call. CONCLUSIONS Preliminary results suggest that nursing diagnoses, interventions, and outcomes can be used to describe patient responses to the fast-track experience. Results indicate a need for practice changes to include innovative models and further research to measure outcomes. Fast-tracking can be effective, but requires clinical reasoning by nurses to guide the individual's healing. A coaching intervention seems to enhance patient satisfaction and a sense of being cared for. [source]

Clinical networks for nursing research

INTERNATIONAL NURSING REVIEW, Issue 3 2002
W. P. Gillibrand MS c
Abstract As a central feature of national research and development strategies, clinical effectiveness emphasizes the importance of rigorous experimental research in nursing. It is naïve to assume that over-worked practitioners, with little research training and supervision, can undertake this type of research. Traditional approaches to research support rely on the practitioner registering for a higher degree and academic supervision. This assumes that the responsibility for research lies with practice, with higher education adopting a reactive stance in supporting research and development in nursing. The literature demonstrates a growing number of innovative models for facilitating nursing research. These, however, tend to focus on single appointments with limited and predefined access to clinical areas and patient populations. This article details a new initiative from the Clinical Nursing Practice Research Unit (CNPRU) that aims to support programmatic research in nursing practice through Clinical Networks for Nursing Research. Our research strategy is to contribute to the development of nursing science by facilitating effective collaboration between clinicians and higher education in core clinical specialties, including stroke rehabilitation, diabetes, mental health and community nursing. Each researcher has developed networks with a number of clinical areas, locally, regionally or nationally, through seminars, conferences or newsletters, to link practitioners and generate answerable research questions. Network communications also rely heavily on the establishment of interactive websites. This strategy has resulted in a number of collaborative, evaluative studies including clinical trials in rehabilitation, diabetic nursing and primary care. [source]

Applying business management models in health care

INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 4 2002
Michael G. Trisolini
Abstract Most health care management training programmes and textbooks focus on only one or two models or conceptual frameworks, but the increasing complexity of health care organizations and their environments worldwide means that a broader perspective is needed. This paper reviews five management models developed for business organizations and analyses issues related to their application in health care. Three older, more ,traditional' models are first presented. These include the functional areas model, the tasks model and the roles model. Each is shown to provide a valuable perspective, but to have limitations if used in isolation. Two newer, more ,innovative' models are next discussed. These include total quality management (TQM) and reengineering. They have shown potential for enabling dramatic improvements in quality and cost, but have also been found to be more difficult to implement. A series of ,lessons learned' are presented to illustrate key success factors for applying them in health care organizations. In sum, each of the five models is shown to provide a useful perspective for health care management. Health care managers should gain experience and training with a broader set of business management models. Copyright © 2002 John Wiley & Sons, Ltd. [source]