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1.
Med Care ; 61(9): 605-610, 2023 09 01.
Article in English | MEDLINE | ID: mdl-37561604

ABSTRACT

BACKGROUND: Language concordance between health care practitioners and patients have recently been shown to lower the risk of adverse health events. Continuity of care also been shown to have the same impact. OBJECTIVE: The purpose of this paper is to examine the relative effectiveness of both continuity of care and language concordance as alternative or complementary interventions to improve health outcomes of people with limited English proficiency. DESIGN: A multivariable logistic regression model using rehospitalization as the dependent variable was built. The variable of interest was created to compare language concordance and continuity of care. PARTICIPANTS: The final sample included 22,103 patients from the New York City area between 2010 and 2015 who were non-English-speaking and admitted to their home health site following hospital discharge. MEASURES: The odds ratio (OR) average marginal effect (AME) of each included variable was calculated for model analysis. RESULTS: When compared with low continuity of care and high language concordance, high continuity of care and high language concordance significantly decreased readmissions (OR=0.71, 95% CI: 0.62-0.80, P<0.001, AME=-4.95%), along with high continuity of care and low language concordance (OR=0.80, 95% CI: 0.74-0.86, P<0.001, AME=-3.26%). Low continuity of care and high language concordance did not significantly impact readmissions (OR=1.04, 95% CI: 0.86-1.26, P=0.672, AME=0.64%). CONCLUSION: In the US home health system, enhancing continuity of care for those with language barriers may be helpful to address disparities and reduce hospital readmission rates.


Subject(s)
Home Care Services , Patient Readmission , Humans , Hospitalization , Language , Patient Discharge , Continuity of Patient Care
2.
J Community Health ; 47(2): 266-272, 2022 04.
Article in English | MEDLINE | ID: mdl-34751895

ABSTRACT

Home health care (HHC) focuses on delivering skilled health care services to patients in their homes. Over 82% of HHC patients are 65 and older, and living with chronic health conditions. In an effort to respond to the risk the COVID-19 pandemic presented for patients, a HHC agency designed "The Outreach Phone Call Project". This program was developed to provide telephone support to at-risk patients who had received HHC prior to the COVID-19 lockdown. In total, 16 Care Transition Managers participated in the project and over 4,000 patients received a call from the clinical team. Approximately 44% of the calls did not require any further follow up, 20% of the patients did not answer the call, and 3% of patients were referred back to HHC. Another 13% needed education and assistance with social issues. The calls provided a means of safe connection and support between providers and patients during the pandemic and facilitated access to health and social resources. However, the most beneficial aspect of the program was the opportunity for seasoned HHC nurses to identify clinical changes in the health of patients and to assist them in the triage process. Results of this study demonstrate that the implementation of a calling project during the pandemic shutdown provided invaluable connection and outreach to vulnerable populations. This simple change in practice enabled HHC professionals to reach patients who were isolated and in need of education and assistance. As a result of the implementation of an "Outreach Phone Call Project", the HHC agency learned many lessons which may be helpful to others who would like to create a similar program in the future. It facilitated clinical assessment, education and intervention for isolated patients during the COVID 19 pandemic and implementation of similar practice should be considered in the post-pandemic world.


Subject(s)
COVID-19 , Adult , Communicable Disease Control , Humans , Independent Living , Pandemics , Telephone
3.
Med Care ; 59(10): 913-920, 2021 10 01.
Article in English | MEDLINE | ID: mdl-34166269

ABSTRACT

BACKGROUND: Home health care (HHC) is a leading form of home and community-based services for persons with dementia (PWD). Nurses are the primary providers of HHC; however, little is known of nursing care delivery and quality. OBJECTIVE: The objective of this study was to examine the association between continuity of nursing care in HHC and rehospitalization among PWD. RESEARCH DESIGN: This is a retrospective cohort study using multiple years (2010-2015) of HHC assessment, administrative, and human resources data from a large urban not-for-profit home health agency. SUBJECTS: This study included 23,886 PWD receiving HHC following a hospitalization. MEASURES: Continuity of nursing care was calculated using the Bice and Boxerman method, which considered the number of total visits, nurses, and visits from each nurse during an HHC episode. The outcome was all-cause rehospitalization during HHC. Risk-adjusted logistic regression was used for analysis. RESULTS: Approximately 24% of PWD were rehospitalized. The mean continuity of nursing care score was 0.56 (SD=0.33). Eight percent of PWD received each nursing visit from a different nurse (no continuity), and 26% received all visits from one nurse during an HHC episode (full continuity). Compared with those receiving high continuity of nursing care (third tertile), PWD receiving low (first tertile) or moderate (second tertile) continuity of nursing care had an adjusted odds ratio of 1.33 (95% confidence interval: 1.25-1.46) and 1.30 (95% confidence interval: 1.22-1.43), respectively, for being rehospitalized. CONCLUSIONS: Wide variations exist in continuity of nursing care to PWD. Consistency in nurse staff when providing HHC visits to PWD is critical for preventing rehospitalizations.


Subject(s)
Continuity of Patient Care , Home Health Nursing , Patient Readmission , Aged , Aged, 80 and over , Dementia , Female , Humans , Logistic Models , Male , Retrospective Studies
4.
J Interprof Care ; 35(2): 193-199, 2021.
Article in English | MEDLINE | ID: mdl-32506976

ABSTRACT

Understanding how previous experiences with interprofessional education and collaboration inform health care provider perspectives is important for developing interprofessional interventions at the graduate level. The purpose of this study was to examine how previous work experiences of graduate level health professions students inform perspectives about interprofessional education and collaboration. Drawing from program evaluation data of two separate graduate level interprofessional education interventions based in primary care and home health care, we conducted a qualitative secondary data analysis of 75 interviews generated by focus groups and individual interviews with graduate students from 4 health professions cadres. Using directed content analysis, the team coded to capture descriptions of interprofessional education or collaboration generated from participants' previous work experiences. Coding revealed 173 discrete descriptions related to previous experiences of interprofessional education or collaboration. Three themes were identified from the analysis that informed participant perspectives: Previous educational experiences (including work-based training); previous work experiences; and organizational factors and interprofessional collaboration. Experiences varied little between professions except when aspects of professional training created unique circumstances. The study reveals important differences between graduate and undergraduate learners in health professions programs that can inform interprofessional education and collaboration intervention design.


Subject(s)
Interprofessional Relations , Students, Health Occupations , Cooperative Behavior , Education, Graduate , Health Occupations , Health Personnel , Humans , Patient Care Team
5.
Geriatr Nurs ; 41(2): 165-171, 2020.
Article in English | MEDLINE | ID: mdl-31668782

ABSTRACT

Despite the rapid increase in the number of persons with dementia (PWD) receiving home health care (HHC), little is known of HHC services patterns to PWD of varied backgrounds, including language preference other than English. Analyzing data of 12,043 PWD from an urban home health agency, we found on average PWD received 2.48 skilled visits or 1.88-hour skilled care and 5.81 aide visits or 24.13-hour aide care weekly. Approximately 63% of the skilled visits were from nurses. More non-English preferred PWD received aide visits, compared to English preferred PWD (44% vs. 36%). The type and intensity of HHC services were associated with language preference; when stratified by insurance, non-English preference was still significantly associated with more HHC aide care. Our study indicated that HHC services (both type and amount) varied by language preference and insurance type as an indicator of access disparities was a significant contributor to the observed differences.


Subject(s)
Dementia/psychology , Dementia/therapy , Home Care Services , Language , Patient Preference , Aged , Aged, 80 and over , Female , Humans , Male , Retrospective Studies , United States
6.
J Wound Ostomy Continence Nurs ; 43(5): 529-38, 2016.
Article in English | MEDLINE | ID: mdl-27488740

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the feasibility of a new Web-based intermittent catheter self-management intervention. DESIGN: We tested the acceptability and usability of intervention components, which included multiple Web-based materials (an online urinary diary adapted for mobile phone use and an educational booklet), 3 phone calls with a nurse, and a peer-led discussion forum. SUBJECTS AND SETTING: Thirty adults with spinal cord injury using intermittent catheterization for bladder drainage were enrolled; 26 participants received the nurses' phone-based consultations. METHODS: Preliminary effectiveness of new self-efficacy and self-management scales were evaluated using baseline and 3-month online surveys. Participants' perceived value of the intervention components, self-management changes, and suggestions were assessed with data from the 3-month surveys, followed by brief tape-recorded interviews. RESULTS: Several catheter practices improved somewhat over 3 months. The frequency of catheterizations every 4 to 6 hours increased from 71% to 77%. Self-management of neurogenic bladder dysfunction increased significantly (P = .032); participant comments indicated that fluid intake was the biggest change. Catheter-related self-efficacy and quality-of-life scores increased but not significantly. The frequency of urinary tract infection and pain did not change significantly. For feasibility, intervention components, with the exception of the forum, were rated highly by the majority of participants for usefulness, satisfaction (desired information), and Web-based usability. CONCLUSION: Further testing of this intervention is recommended in a multisite randomized clinical trial.


Subject(s)
Intermittent Urethral Catheterization/methods , Patient Education as Topic/standards , Self Care , Spinal Cord Injuries/complications , Adult , Female , Humans , Intermittent Urethral Catheterization/standards , Intermittent Urethral Catheterization/statistics & numerical data , Internet , Male , Middle Aged , Patient Education as Topic/methods , Patient Education as Topic/statistics & numerical data , Qualitative Research , Spinal Cord Injuries/therapy , Surveys and Questionnaires , Teaching/standards , Urinary Tract Infections/prevention & control
7.
Comput Inform Nurs ; 33(11): 478-86, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26361267

ABSTRACT

While Web-based interventions have proliferated recently, information in the literature is often lacking about how the intervention was developed. In response to that gap, this is a report of the development of a Web-based self-management intervention for intermittent urinary catheter users and pretesting with four adults with spinal cord injury living in the community. Two Web sites were created, one for recruitment and the other for the intervention itself. The intervention involved developing new Web-based technology, including an interactive urinary diary (with fluid intake/urine output and a journal), extensive catheter products information, three intervention nurse phone call consultations, and user-community discussion forums. Study participants completed an online survey and were interviewed twice about the enrollment process and their perceptions of their involvement in the intervention. Suggestions from the pretesting participants were used to revise the Web site applications prior to the next stage of research (a feasibility study). Numerous recommendations and comments were received related to content, interactivity of components, and usability. This article provides a description of how the Web sites were developed (including the technology and software programs used), issues encountered and what was done to address them, and how the Web-based intervention was modified for improvements.


Subject(s)
Intermittent Urethral Catheterization/methods , Internet , Patient Education as Topic/methods , Self Care , Spinal Cord Injuries/complications , User-Computer Interface , Adult , Female , Humans , Interviews as Topic , Male , Nursing Informatics , Surveys and Questionnaires
8.
Urol Nurs ; 35(3): 127-33, 138, 2015.
Article in English | MEDLINE | ID: mdl-26298947

ABSTRACT

A new Web-based self-management intervention was developed for persons with spinal cord injury who use intermittent urinary catheters. Included are a description of the components, examples from the educational book, and multiple screen shots of the online urinary diary.


Subject(s)
Internet , Patient Education as Topic , Self Care , Spinal Cord Injuries/complications , Urinary Catheterization/methods , Catheter-Related Infections/prevention & control , Cell Phone , Humans , Quality of Life , User-Computer Interface
9.
J Occup Environ Med ; 65(5): 387-393, 2023 05 01.
Article in English | MEDLINE | ID: mdl-36728191

ABSTRACT

OBJECTIVE: The purpose of the study is to evaluate the effect of an online educational module in increasing awareness of depression, substance use disorder, and sleep deprivation among firefighters in Monroe County, New York. METHOD: Firefighters were recruited via work e-mail and the snowball technique. A quantitative preintervention and postintervention study was used. Participants completed four surveys before and after completing educational online modules. RESULTS: There was a 5.11% increase in overall knowledge about sleep deprivation, depression, and substance (alcohol) use and a small decrease in the group mean for the depression and sleep deprivation scores after completion of the educational modules. CONCLUSION: Increasing content knowledge had a positive effect to participants' self-awareness during the project. Incorporating educational modules into annual firefighting training could provide opportunities to improve sleep deprivation, depression, and substance use.


Subject(s)
Education, Distance , Firefighters , Humans , Sleep Deprivation , Educational Status , Alcohol Drinking
10.
PEC Innov ; 2: 100177, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37384163

ABSTRACT

Objective: The purpose of this study was to understand the limited English proficiency patient experience with health care services in an urban setting in the United States. Methods: Through a narrative analysis approach, 71 individuals who spoke either Spanish, Russian, Cantonese, Mandarin, or Korean shared their experiences through semi-structured interviews between 2016 and 2018. Analyses used monolingual and multilingual open coding approaches to generate themes. Results: Six themes illustrated patient experiences and identified sources of structural inequities perpetuating language barriers at the point of care. An important thread throughout all interviews was the sense that the language barrier with clinicians posed a threat to their safety when receiving healthcare, citing an acute awareness of additional risk for harm they might experience. Participants also consistently identified factors they felt would improve their sense of security that were specific to clinician interactions. Differences in experiences were specific to culture and heritage. Conclusions: The findings highlight the ongoing challenges spoken language barriers pose across multiple points of care in the United States' health care system. Innovation: The multi-language nature of this study and its methodological insights are innovative as most studies have focused on clinicians or patient experiences in a single language.

12.
Health Care Women Int ; 33(4): 321-41, 2012.
Article in English | MEDLINE | ID: mdl-22420675

ABSTRACT

The impact of a professionally facilitated peer group intervention for HIV prevention among 400 low-income Chilean women was examined using a quasiexperimental design. At 3 months postintervention, the intervention group had higher HIV-related knowledge, more positive attitudes toward people living with HIV, fewer perceived condom use barriers, greater self- efficacy, higher HIV reduction behavioral intentions, more communication with partners about safer sex, and decreased depression symptoms. They did not, however, have increased condom use or self-esteem. More attention to gender barriers is needed. This intervention offers a model for reducing HIV for women in Chile and other Latin American countries.


Subject(s)
HIV Infections/prevention & control , Health Knowledge, Attitudes, Practice , Sexual Behavior , Adult , Chile , Condoms/statistics & numerical data , Depression/diagnosis , Depression/psychology , Female , Follow-Up Studies , HIV Infections/psychology , Hispanic or Latino , Humans , Interviews as Topic , Logistic Models , Male , Middle Aged , Peer Group , Poverty , Risk Reduction Behavior , Self Efficacy , Sexual Partners , Young Adult
13.
Int J Nurs Stud ; 125: 104093, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34710627

ABSTRACT

BACKGROUND: In home health care, language barriers are understudied. Language barriers between patients and providers are known to affect a variety of patient outcomes. How a patient's language preference influences hospital readmission risk from home health care has yet to be determined. OBJECTIVE: To determine if home care patients' language preference is associated with their risk for hospital readmission from home health care within 30 days of hospital discharge. DESIGN: Retrospective cross-sectional study of hospital readmissions from an urban home health care agency's administrative records and the national electronic home health care record for the United States, captured between 2010 and 2015. SETTING: New York City, New York, USA. PARTICIPANTS: The dataset comprised 90,221 post-hospitalization patients and 6.5 million home health care visits. METHODS: First, a Chi-square test was used to determine if there were significant differences in crude readmission rates based on language group. Inverse probability of treatment weighting was used to adjust for significant differences in known hospital readmission risk factors between to examine all-cause hospital readmission during a home health care stay. The final matched sample included 87,561 patients with a language preference of English, Spanish, Russian, Chinese, or Korean. English-speaking patients were considered the comparison group to the non-English speaking patients. A Marginal Structural Model was applied to estimate the impact of non-English language preference against English language preference on rehospitalization. The results of the marginal structural model were expressed as an odds ratio of likelihood of readmission to the hospital from home health care. RESULTS: Home health patients with a non-English language preference had a higher hospital readmission risk than English-speaking patients. Crude readmission rate for the limited English proficiency patients was 20.4% (95% CI, 19.9-21.0%) overall compared to 18.5% (95% CI, 18.7-19.2%) for English speakers (p < 0.001). Being a non-English-speaking patient was associated with an odds ratio of 1.011 (95% CI, 1.004-1.018) in increased hospital readmission rates from home health care (p = 0.001). There were also statistically significant differences in readmission rate by language group (p < 0.001), with Korean speakers having the lowest rate and Spanish speakers having the highest, when compared to English speakers. CONCLUSIONS: People with a non-English language preference have a higher readmission rate from home health care. Hospital and home healthcare agencies may need specialized care coordination services to reduce readmission risk for these patients. Tweetable abstract: A new US-based study finds that home care patients with language barriers are at higher risk for hospital readmission.


Subject(s)
Home Care Services , Patient Readmission , Communication Barriers , Cross-Sectional Studies , Hospitals , Humans , Language , Retrospective Studies , United States
14.
Rev Med Chil ; 139(5): 625-32, 2011 May.
Article in Spanish | MEDLINE | ID: mdl-22051714

ABSTRACT

BACKGROUND: In Chile, members of the civil society and government achieved the passing of the HIV/AIDS Law (19.779). The level of knowledge of the law held by healthcare workers in Chile is not well known. AIM: To analyze the effect of an intervention on knowledge of the existence of the law and its application in clinical practice among primary healthcare workers in southeastern Santiago. MATERIAL AND METHODS: Healthcare workers of primary care centers were invited to participate in the study. One group received an educational intervention lasting a total of 16 hours, about AIDS physiopathology, sexually transmitted diseases, communication with patients and current legislation. A control group did not receive the educational intervention. Both groups answered a self-administered questionnaire about the HIV/AIDS law at baseline and three months after the intervention. RESULTS: The intervention was carried out in 262 workers and 293 participated as controls. The initial evaluation revealed that only 16.3% (n = 89) had heard of the law, without any significant difference between intervention and control groups. The knowledge about the law improved by 65% in the intervention group and did not change in controls. At the end of the education period, the intervention and control groups improved their global knowledge by 29 and 3%, respectively (p < 0.05). CONCLUSIONS: The educational intervention was effective in improving knowledge of the HIV/AIDS Law among Chilean healthcare workers.


Subject(s)
Acquired Immunodeficiency Syndrome/prevention & control , Health Knowledge, Attitudes, Practice , Health Personnel/education , Human Rights/legislation & jurisprudence , Legislation, Medical , Adult , Case-Control Studies , Chile , Educational Status , Female , Humans , Male , Primary Health Care , Program Development , Program Evaluation , Truth Disclosure
15.
Patient Educ Couns ; 104(3): 534-553, 2021 03.
Article in English | MEDLINE | ID: mdl-32994104

ABSTRACT

OBJECTIVE: Global migration and linguistic diversity are at record highs, making healthcare language barriers more prevalent. Nurses, often the first contact with patients in the healthcare system, can improve outcomes including safety and satisfaction through how they manage language barriers. This review aimed to explore how research has examined the nursing workforce with respect to language barriers. METHODS: A systematic scoping review of the literature was conducted using four databases. An iterative coding approach was used for data analysis. Study quality was appraised using the CASP checklists. RESULTS: 48 studies representing 16 countries were included. Diverse healthcare settings were represented, with the inpatient setting most commonly studied. The majority of studies were qualitative. Coding produced 4 themes: (1) Interpreter Use/Misuse, (2) Barriers to and Facilitators of Quality Care, (3) Cultural Competence, and (4) Interventions. CONCLUSION: Generally, nurses noted like experiences and applied similar strategies regardless of setting, country, or language. Language barriers complicated care delivery while increasing stress and workload. PRACTICE IMPLICATIONS: This review identified gaps which future research can investigate to better support nurses working through language barriers. Similarly, healthcare and government leaders have opportunities to enact policies which address bilingual proficiency, workload, and interpreter use.


Subject(s)
Communication Barriers , Quality of Health Care , Allied Health Personnel , Delivery of Health Care , Humans , Workload
16.
Home Healthc Now ; 38(4): 209-214, 2020.
Article in English | MEDLINE | ID: mdl-32618779

ABSTRACT

When compared with their heterosexual cisgender (nontransgender) counterparts, LGBTQ+ older adults are more likely to delay or not seek medical care, often due to fear of real or perceived discrimination from healthcare providers. HCR Home care is a home healthcare agency in Upstate New York that has been delivering high-quality in-home healthcare services for over 40 years. We recognized that we had a unique opportunity to address the vulnerabilities of older adults in the LGBTQ+ community and to better meet their health needs as they age in place. We developed a five-step process to implement a program to better serve the home healthcare needs of the LGBTQ+ population in our community. The goal of this initiative is to provide ongoing community education on home healthcare, awareness of the social and health issues surrounding LGBTQ+ older adults, and ultimately to improve care and decrease health disparities. This article describes the five-step process, the challenges, successes, and implications for the future. Ensuring there are healthcare solutions available for vulnerable and marginalized individuals is key to changing the way home healthcare is structured and improving quality of life and health outcomes for all.


Subject(s)
Home Care Services/organization & administration , Sexual and Gender Minorities , Aged , Female , Humans , Male , New York , Prejudice , Program Development , Program Evaluation , Vulnerable Populations
17.
Med Care Res Rev ; 77(6): 609-619, 2020 12.
Article in English | MEDLINE | ID: mdl-30730237

ABSTRACT

A primary service provided by home care is medication management. Issues with medication management at home place older adults at high risk for hospital admission, readmission, and adverse events. This study sought to understand medication management challenges from the home care provider perspective. A qualitative secondary data analysis approach was used to analyze program evaluation interview data from an interprofessional educational intervention study designed to decrease medication complexity in older urban adults receiving home care. Directed and summative content analysis approaches were used to analyze data from 90 clinician and student participants. Medication safety issues along with provider-provider communication problems were central themes with medication complexity. Fragmented care coordination contributed to medication management complexity. Patient-, provider-, and system-level factors influencing medication complexity and management were identified as contributing to both communication and coordination challenges.


Subject(s)
Data Analysis , Home Care Services , Communication , Humans , Qualitative Research
18.
Int J Nurs Stud ; 99: 103394, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31479983

ABSTRACT

BACKGROUND: Increasingly, patients with limited English proficiency are accessing home health care services in the United States. Few studies have examined how language barriers influence provider role implementation or workload in the home health care setting. OBJECTIVES: To explore home health care professionals' perspectives about how workload changes from managing language barriers influence quality and safety in home health care. DESIGN: A qualitative secondary data analysis using a summative content analysis approach was used to analyze existing semi-structured interview data. SETTING: A large urban home health care agency located on the East Coast of the United States. PARTICIPANTS: Thirty five home health care providers [31 registered nurses, 3 physical therapists, 1 occupational therapist]. RESULTS: A total of 142 discrete incidents emerged from the analysis. Overall, home health care providers experienced distinct shifts in how they implemented their roles that added to their workload and time spent with Limited English Proficiency patients and family members. Providers were concerned about interpretation accuracy and perceived it as potentially posing risks to patient safety. Changes in work patterns, therefore, sought to maximize patient safety. CONCLUSIONS: Home health care providers decision-making about how they adapt practice when faced with a language barrier is a sequence of actions based on awareness of the patient's language preference and if they spoke another language. Subsequent choices showed proactive behaviors to manage increased workload shaped by their perceived risk of the threats posed by the quality of interpreter services. Future research should develop quantitative models examining differences in workload when caring for limited English proficiency versus English speaking patients as well as the relationship between visit length and patient outcomes to determine optimal quality models.


Subject(s)
Communication Barriers , Home Care Services/organization & administration , Workload , Family , Humans , Patient-Centered Care , United States
19.
Res Theory Nurs Pract ; 33(3): 257-274, 2019 08 01.
Article in English | MEDLINE | ID: mdl-31615945

ABSTRACT

BACKGROUND: Compelling evidence indicates that gaps in quality, safety, and experiences occur when patients encounter transitions across the care continuum. Differences in the organization of healthcare services as well as disparities in health across the globe, may have a unique impact on processes associated with transitions of care for client populations. PURPOSE: Increased attention to the concept of transitions of care has resulted in disparate meanings and lack of clarity about its nature. Therefore, the purpose of this manuscript is to address this knowledge gap by analyzing the concept of transitions of care at the population level. METHODOLOGY: To address the knowledge gap of what constitutes transitions of care at the population level, a concept analysis was done guided by the methodology of Walker and Avant. A comprehensive search of the literature yielded a small but relevant number of publications. RESULTS: This analysis identified four defining attributes, together with antecedents and consequences of transitions of care at the macro-system level of healthcare. A synthesized definition of transitions of care was developed. IMPLICATIONS FOR PRACTICE: This analysis provides conceptual clarity for the concept of transitions of care at the macro-system level of care. It can be used to guide the development of a middle-range theory to inform clinical practice and health policy.


Subject(s)
Concept Formation , Continuity of Patient Care , Models, Nursing , Population Health , Chronic Disease , Evidence-Based Nursing , Humans
20.
J Assoc Nurses AIDS Care ; 19(3): 235-41, 2008.
Article in English | MEDLINE | ID: mdl-18457766

ABSTRACT

Chile is a country with an incipient HIV epidemic. Just as in other countries, disadvantaged groups in Chile are contributing to the increased incidence of the disease. The Mapuche indigenous population is one such group that has been affected by the spread of HIV. However, no prevention programs are tailored to the culturally specific needs of this community. In recognition of this discrepancy, an academic-community partnership was formed to develop an HIV educational module for a Mapuche community. The module was developed for use as part of an already established health-related program. The aims of the module were to identify perceptions about HIV among Mapuches and present information specific to HIV and its prevention. Focus was placed on cultural sensitivity. A total of 16 Mapuches participated voluntarily and showed some knowledge regarding HIV, but they lacked an overall understanding as to how it is transmitted and why prevention strategies are effective. Continued collaboration between academia and affected communities as well as incorporating HIV information into established programs are effective strategies for delivering prevention information to disadvantaged populations and for further understanding their perceptions and health care needs.


Subject(s)
HIV Infections/epidemiology , Indians, South American , Chile/epidemiology , Cooperative Behavior , HIV Infections/prevention & control , Health Status Indicators , Humans
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