COMPLEXITY IN NURSING EDUCATION: EXAMPLES OF THE PARADIGM

Edgar Morin proposed that knowledge construction is best enacted via a complex and circular approach between both the part and the whole, while never enacting a strictly reductionistic or strictly holistic approach. It is the ability to connect and unite the parts within the whole via a dynamic circular process between the parts and whole that frees us from fragmented knowledge and helps us to bridge the gap between our seemingly disparate-competing nursing paradigms. This article examines the benefits of utilizing Morin's complexity theory, the dialogical, and circular processes in creating a liberating structural framework or paradigm for nursing education.     

论现代临床护理决策的“非语言性”道德语境

现代临床护理决策的“非语言性”道德语境包括道德多元化、患者中心化和责任独立化三个主要方面.对“非语言性”道德语境的忽视导致了护理决策缺乏公信力.临床护理决策伦理模式的建构能使护理决策主体充分考虑“非语言性”道德语境,有利于道德争议的有效解决.     

Religiousness and Subjective Well-Being Among Jewish Female Residents of Old Age Homes in Israel

ABSTRACT

The present study explored the prevalence of religiousness among Jewish elderly women residing in old age homes in Israel and its impact on their subjective well-being. The sample included 464 respondents residing in 48 old age homes. Religiousness was measured through self-rated religiousness and religious faith scales (Ben Meir & Kedem, 1979). Subjective well-being was measured by the PGC (Philadelphia Geriatric Center) Morale Scale (Lawton, 1975). The findings revealed that the majority of the elderly define themselves as traditional, orthodox or ultra orthodox. Multiple regression analysis revealed that religiousness did not affect the residents' subjective well-being.     

Consequences of Violence Exposures by Emergency Nurses

Emergency nurses are among the most likely groups of health care professionals to be exposed to violence. Violence exposure is the witnessing or receiving of a violent act with or without the intention to cause physical or psychological harm. The purpose of this paper is to evaluate the literature in relation to emergency nurses' exposure to violence and discuss the implications for emergency nursing practice. A review of the literature was conducted using the keywords violence, emergency nursing, health care workers, and productivity. Emergency nurses exhibited anxiety, vulnerability, guilt, anger, sadness, and peer blaming following violence exposures. Violence exposures affect emergency nurses both physically and psychologically. Interventions should be developed to reduce the negative consequences of violence exposures.     

放弃治疗后，以护理为主导的医学服务和人文关怀

剖析放弃治疗后死亡病案508例,分析放弃治疗的原因、疾病和形式,放弃治疗后护理工作存在的问题。提出在放弃治疗后,临床护理决策：对于护理工作发生的变化,应该提高认识,培养护理人员人文素质和法律意识,应该加强护理管理和规范,放弃治疗后,护理应该承担医学服务和人文关怀的主导作用。     

武汉市老年护理医院出院患者疾病构成帕累托图分析

为了解武汉市老年护理医院患者主要病种、多发病种构成情况,以武汉市5家老年护理医院的病案统计数据为资料,运用帕累托图分析法对1236例出院患者的情况进行分析。武汉市老年护理医院患者中病种以心血管病、脑血管病、脑卒中后遗症、慢性支气管炎、糖尿病、肺气肿、骨折等疾病为主,其构成占到老年护理医院出院病例疾病构成的90％以上。     

用批判性思维方法解决烧伤护理实践中的问题

批判性思维是护理界越来越注重培养并予运用的思维方法。在烧伤护理实践中用批判性思维方法解决临床护理实际问题,护理人员应正确理解批判性思维的概念并培养批判性思维能力、应具备良好的职业道德和敬业精神,最终能将批判性思维正确运用于护理程序的每一个步骤中。     

THE MANAGEMENT OF DEHYDRATION AND INCONTINENCE IN NONAMBULATORY GERIATRIC PATIENTS

We evaluated a health care routine designed to decrease incontinence and improve the hydration level of nonambulatory nursing home patients. To implement this routine, a 3′ × 4′ cart was equipped with liquids and toileting equipment. A nurse's aid was assigned the task of taking the cart to each nonambulatory resident in a nursing home and offering specified assistance on a regular basis. Data demonstrated a decrease in physical dehydration, as well as in fecal and urinary incontinence.     

AN EVALUATION OF TEACHING-FAMILY (ACHIEVEMENT PLACE) GROUP HOMES FOR JUVENILE OFFENDERS

Juvenile crime is a serious problem for which no treatment approach has been found to be reliably effective. This outcome evaluation assessed during and posttreatment effectiveness of Teaching-Family group home treatment programs for juvenile offenders. The evaluation included the original Achievement Place program, which was the prototype for the development of the Teaching-Family treatment approach, 12 replications of Achievement Place, and 9 comparison group home programs. Primary dependent measures were retrieved from court and police files and included number of alleged offenses, percentage of youths involved in those alleged offenses, and percentage of youths institutionalized. Other dependent measures were subjective ratings of effectiveness obtained from the program consumers, including the group home residents. The results showed difference during treatment favoring the Teaching-Family programs on rate of alleged criminal offenses, percentage of youths involved in those offenses, and consumer ratings of the programs. The consumer ratings provided by the youths and their school teachers were found to be inversely and significantly correlated with the reduction of criminal offenses during treatment. There were no significant differences during treatment on measures of noncriminal offenses (e.g., truancy, runaway, and curfew violations). In the posttreatment year, none of the differences between the groups was significant on any of the outcome measures. The results are discussed in terms of measurement and design issues in the evaluation of delinquency treatment programs and in relation to the evaluation of Teaching-Family group homes by Richard Jones and his colleagues.     

MANAGEMENT OF GERIATRIC INCONTINENCE IN NURSING HOMES

A behavioral management system designed to reduce urinary incontinence was evaluated in two nursing homes with a pretest-posttest control group design with repeated measures. The primary components of the system were prompting and contingent social approval/disapproval which required approximately 2.5 minutes per patient per hour to administer. The frequency of correct toileting for experimental subjects increased by approximately 45%. The experimental groups were significantly different from the control groups on both incontinence and correct toileting measures. The results are discussed in view of the management issues inherent in nursing home settings.