Cigarette smoking and the frequency of colposcopy visits, treatments and re-referral.

Current research has confirmed that cigarette smoking is a risk factor for cervical cancer. Although more recently, there has been a slight decline in smoking rates, the relationship between tobacco use and cervical cancer remains clear. The development of research-based knowledge with which to inform the profession will assist practitioners to promote smoke-free practices for women and their families. The aim of this study was to identify whether female smokers referred to the colposcopy department at a city hospital required more follow-up visits, treatments and re-referrals than did nonsmokers. This retrospective descriptive study observed new patients (n= 494) who attended a city hospital colposcopy department in 2001 over the following six years. When compared to non-smokers women who smoked were found to be three times more likely to need a third follow-up visit, and twice more likely to need further treatments to remove abnormalities. This study also identified that 71% of Miori women attending the clinic were smokers compared to 44% of non-Maori women. It was also found that MSori women were less likely to attend the colposcopy clinic than were non-Maori. This study highlights to health professionals and to the women who undergo colposcopy, that treatment is more likely to be successful for patients who cease smoking. The results have also supported the importance and relevance of smoke-free education to women. This allows the link to cervical abnormalities and smoking to be explained and smoking cessation assistance offered. This information also highlights the need for Maori women, who are more likely to smoke and have higher rates of non-attendance for appointments, to have services provided that will encourage attendance and smoke-free behaviour.

Community analysis for health planning with vulnerable populations.

This article describes how advanced practice nurses used a theory-based community health analysis process to examine the healthcare services most needed and used by an adult public housing community and to examine the satisfaction of the community with those services. The goal of the project was to determine if the identified needs would be amenable to an alternative healthcare delivery model, such as an academic nursing clinic. Data were collected using the Health Needs and Health Status Survey, Center for Epidemiological Studies-Depression scale, interactive participant interviews, key informant interviews and observations. Community residents (N = 242) were typically unmarried, middle-aged, and low income and had multiple chronic physical illnesses, serious and persistent mental illnesses, and/or disabilities. Despite the high identified service need, use of preventative or routine healthcare services was low, with residents using emergency services inappropriately or delaying care until requiring more expensive intensive healthcare services.

Using vignettes to study nurse practitioners' performance in suspected domestic violence situations.

Vignettes have often been used to evaluate students or collect data in nursing research. The format is familiar to most nursing students as well as nurses and nurse researchers. This article presents the development and testing of the Nurse Practitioner Performance Tool (NPPT) which used vignettes as an approach to nurse practitioner performance evaluation. In this example, vignettes were used in a quasi-experimental design to collect data from Adult and Family Nurse Practitioners (A/FNP). The focus was on the diagnosis and intervention performance of the A/FNPs when addressing suspected cases of domestic violence.

Depression, service need, and use in vulnerable populations.

Health care reform has created opportunities for mental health nurses to develop innovative health care delivery models to provide integrated behavioral health and primary health care. A community health analysis is one method to ensure appropriate services are planned. This study examined the health care services most needed and those used by depressed and nondepressed participants (N = 231), and their satisfaction with these services. Individual and system characteristics were examined using a framework developed by Anderson and Aday. Significant differences were found between the 2 groups for predisposing characteristics, enabling characteristics, need for care, service use, and satisfaction with services.

Nurse practitioner interventions for domestic violence.

The purposes of this study were to (1) identify interventions used by a sample of adult and family nurse practitioners (NPs) with suspected cases of domestic violence and (2) determine if the interventions used had theoretical and empirical support. Sixty vignette responses from 20 NPs were analyzed using content analysis and compared with the literature. The NPs in this sample diagnosed domestic violence in only 60% of the cases. A total of 12 intervention categories (e.g., screening, physical examination, medical treatment, or counseling) were developed. Twelve categories were theoretically supported, and one category had empirical support. These findings support the need for heightened awareness of domestic violence for proper diagnosis and for use of theoretically and empirically supported interventions.

Correlates of nurse practitioners' diagnostic and intervention performance for domestic violence.

The purposes of this research were to identify diagnosis and intervention performance accuracy, variables that influence this performance accuracy, and barriers that impede performance accuracy of adult nurse practitioners (ANP) and family nurse practitioners (FNP) for domestic violence. Two measures were developed: the Nurse Practitioner Survey (NPS) and the Nurse Practitioner Performance Tool. A total of 118 ANPs and FNPs completed and returned mailed surveys. Of these, 22 individuals were interviewed by telephone regarding personal and professional experience with domestic violence and barriers in their clinical settings to addressing domestic violence.