Computerized documentation of case management. From diagnosis to outcomes.

Documentation of patient care, outcomes, and report writing are important aspects of the role of the case manager. In this article, the author examines the types of documentation approaches used by nurses in recent years and the new applications called for in the case manager role. Issues such as standardized language and multidisciplinary documentation are explored. Approaches to examining computerized documentation systems are presented. Finally, the importance of documentation in demonstrating what nurses do, allowing comparison of outcomes, and supporting reimbursement for nurses, are discussed.

Implementation and outcomes of a community-based self-help smoking cessation program.

In a time of budget constraints, health professionals are turning to minimal-contact smoking cessation programs as the most financially feasible alternative for smoking cessation. The purpose of this study was to evaluate a program by the American Lung Association using the manual Freedom From Smoking for You and Your Family (Strecher & Rimer, 1988) in a community-based smoking cessation self-help intervention. Results showed a quit rate of 15%, and study findings were consistent with other similar studies. Those most likely to succeed were over 40 years old, better educated, and among the most confident of quitting at the onset.

A community-based smoking-cessation program: self-care behaviors and success.

Given the serious health consequences of smoking, nurses need to be well-informed on how to help various client populations with smoking cessation. Much recent research is focused upon effectiveness of various programs to enhance self-efficacy and self-management skills necessary to succeed in permanent smoking cessation. This study used a model based on Orem's Self-Care Deficit Theory to examine specific variables of importance in smoking cessation using descriptors relevant to understanding self-care actions. The model is used to examine the outcomes of a community-based smoking-cessation program. Results indicate that 15% of the final sample quit smoking and 42% reduced smoking while participating in the program. Additional findings are helpful in describing actions taken by subjects who were and were not successful in quitting. Remedies suggested by the American Lung Association booklet "Freedom from Smoking for You and Your Family" were reported by subjects to be helpful in dealing with the most common problems experienced during smoking cessation. Results are applied to public health nursing, emphasizing that smoking cessation is "a process" in which individuals learn strategies that work for them.

Mitral valve prolapse and its effects: a programme of inquiry within Orem's Self-Care Deficit Theory of Nursing.

The optimum growth and scientific progress of nursing knowledge during the next century will depend upon the development and execution of focused programmes of clinical and theoretical research. The planning and design of such programmes must originate with the clear definition of nursing research questions. Nesting such questions within established theoretical frameworks provides a nursing context, lends precise language and suggests relevant variables for study. The development of a sequence of related studies exploring and describing the self-care needs of people with symptomatic mitral valve prolapse illustrates one such systematic research programme. Orem's Self-Care Deficit Theory of Nursing was used as a theoretical framework for four completed studies which describe one population's need for nursing assistance. The evolving nature of the research programme and plans for future research are discussed.

Perspectives of the person with mitral valve prolapse syndrome: a study of self-care needs derived from a health deviation.

Epidemiological studies in the United States indicate that 5% of the population or nearly 7 million people have Mitral Valve Prolapse. This incidence has also been confirmed by British physicians. Approximately half of these persons seek medical care for treatment of symptoms. Persons with symptoms are often said to have "Mitral Valve Prolapse Syndrome." The purpose of this study was to describe experiences and self-care needs of persons diagnosed with Mitral Valve Prolapse Syndrome (MVPS). In Phase I of the study, medical records of 124 subjects were reviewed to identify the medical experience and typical symptoms associated with MVPS. In Phase II, 20 subjects with typical symptoms were interviewed using a semi-structured questionnaire based on health deviation self-care requisites developed by Orem. Results of this pilot study indicate that interviewed subjects with MVPS frequently had unresolved health concerns and were seeking help. Nursing assistance may therefore be needed to help such clients understand this health deviation, to make decisions regarding appropriate actions, and to accomplish self-care actions.