Defining and measuring service awareness among elders and caregivers of Mexican descent.

Mexican American elders' and their caregivers' awareness of available home care services is one of nine factors hypothesized to be associated with underuse of home care services. Previous instruments did not fully measure service awareness. The objective of this study was to explore the conceptual foundation of service awareness, generate items, and establish language equivalence in Spanish and English for the Service Awareness Scale. A hybrid use of the literature and fieldwork were used to develop the concept and generate items. The team used back-translation and community collaboration to test for language equivalence. Concept development and language equivalence were achieved for the Service Awareness Scale. Teaching/learning theories contributed to the definition and inductive validity of service awareness and item generation and can shape future interventions. Bicultural/bilingual community and research team partners refined its measure. The scale will be usable in research and practice designed to promote equity in health care use.

The language of breathing among individuals with chronic obstructive pulmonary disease.

OBJECTIVE: To examine the consistency of language used by adults with chronic obstructive pulmonary disease (COPD) and to describe and evaluate their everyday breathing. METHODS: A longitudinal descriptive design was used. Eleven subjects with stable COPD and moderate to severe lung impairment were enrolled at the study site and completed daily and weekly measures at home. Participants recorded descriptions of breathing in logs and rated breathing distress and effort once a day on visual analogue scales for 28 days. Participants also selected endorsed descriptors at baseline and once per week thereafter. RESULTS: Consistency was low to moderate between baseline and weekly endorsed descriptors, weekly endorsed and logged descriptors, and logged descriptors and VAS scores for breathing distress and effort. CONCLUSIONS: This study provides the first naturalistic record of everyday breathing intensity logged by individuals with moderate to severe COPD. The variability in expression of breathing intensity was associated with low to moderate consistency. Because language drives care seeking, further research is essential to understand language selection for describing symptoms of breathing intensity.

Open exchange as a model for continuing education.

The Global Nursing Exchange is a unique, annual opportunity for a select group of nurses to confer with each other and learn in an unstructured, nonrestrictive forum for free uncensored exchange of ideas. It is an unusual "conference" in that both the structure and process have been designed to encourage spontaneity, creativity, and group sharing. Relaxation and work comingle. Networking, dialog, and inclusiveness are operating themes at all times. Started in 1988 by 9 nurses with a mix of backgrounds and experience, the Global Nursing Exchange has expanded to include international participants. In 2003, over 60 nurses joined in celebrating the 15th year of this group gathering. Examples of outcomes that have resulted from this unique "conferencing" experience are described.

Circle communication: an old form of communication useful for 21st century leadership.

Circle communication is a form of group exchange that builds a network of relationships, a sense of community. Through practices of active listening, intentional speaking, and conscious self-monitoring, circle communication emphasizes individual contribution while building consensus to fulfill the purpose of the group. In this regard, circle communication supports a shared leadership in which all individual and unique perspectives are engaged to create the common ground for action. Circle communication emerges from a shared humanity, which can balance the "division of labor" and people only being known by their specific organizational roles. Both are needed to sustain an organization. By nurturing the human side, regardless of role and function, circle communication intersects with diversity or the uniqueness of each individual, storytelling, coaching, guiding, and mentoring, as well as discovering and responding to conflict.