Decoding the Miss Daisy Syndrome: an examination of subjective responses to mobility change.

The subjective responses associated with personal life space and mobility status were explored. Thirty individuals participated in focus groups based on self-rated disability status, current places visited, and availability. Qualitative analyses revealed that most participants equated personal mobility with driving a vehicle. Attitudes concerning mobility status and preparedness for change varied based on disability level and personal experience. Fear of dependence from future mobility loss was prominent in all groups. Few participants acknowledged significant planning for future retirement from driving or other mobility challenges. An understanding of common attitudes, perceptions and meanings can inform professionals who intervene and support older adults experiencing mobility changes.

Perceptions of pharmaceutical care among pharmacists offering compounding services.

OBJECTIVES: To identify and describe pharmaceutical care practices implemented by independent community pharmacists who provide compounding services. DESIGN: Qualitative study. SETTING: Independent community pharmacies in Illinois, Missouri, and Iowa in July 2006. PARTICIPANTS: 12 independent community pharmacists with compounding practices. INTERVENTIONS: Semistructured telephone interviews. MAIN OUTCOME MEASURES: Response themes describing pharmaceutical care in compounding practices. RESULTS: Most participants described having a closer relationship with patients receiving compounded preparations than with patients receiving only manufactured products. Higher compounded prescription volume was associated with a higher level of pharmaceutical care services for patients receiving compounded preparations. Patient health and prescription records, the nature and duration of patient counseling, and interaction with physicians differed depending on the type of preparation (compounded or manufactured) provided. CONCLUSION: Community pharmacists provided descriptions of pharmaceutical care and their satisfaction with patient and pharmacist relationships in the context of providing compounded preparations. Pharmacists, especially those providing compounded hormone replacement therapy, developed a hybrid clinical-community practice.

Evaluation of outcomes in Psychiatric Consultation-Liaison Nursing practice.

This report describes and evaluates the current status of outcome analysis in Psychiatric Consultation-Liaison Nursing (PCLN) and offers suggestions for future development. The status of outcome evaluation generally in psychiatric nursing is described with attention given to the scope of practice of PCLN and outcomes used by psychiatric consultation-liaison nurses (PCLNs) to evaluate their interventions. An evaluation framework based on Donabedian's paradigm of structure, process, and outcome is presented and its applicability shown to PCLN. This framework is further explicated with regard to a review of published studies of PCLN within the outcome domains of cost reduction, satisfaction with services, changes in clinical status, and perceptions of work environment. Finally, recommendations for further development of outcomes in PCLN are offered, based on the strengths and limitations of the extant literature.