Hospital-based partner assault clinics are a relatively recent addition to the community response to partner violence. In this study, 66% of 111 women attending hospital clinics for partner assault were physically injured and 43% reported death threats. Few concurrently used other services (shelters or police) and most relied on female friends and relatives for help. Many participants who currently lived with the perpetrator were contemplating leaving but only a third had made plans to do so. Participants faced an unusually high risk of future assault, according to both victim interview using the ODARA actuarial risk assessment and their own perceptions. Findings imply an important role for partner assault clinics and the feasibility of the victim service sector's using the same actuarial risk assessments as the criminal justice system.
In this article the psychometric properties of an Abilities Assessment Instrument (AAI), developed to assess the self-care, social, interactional and interpretive abilities of older people with cognitive impairment (CI) related to dementia, are described. The sample consisted of 112 institutionalized older men with CI and 60 institutionalized older men without CI. The psychometric evaluation of the AAI indicated that: (a) it is reliable in terms of test-retest (Pearson's r range .93-.99), interrater (Pearson's r range .95- .99), and internal consistency evaluations (Cronbach's alpha .90-.98), as well as through confirmatory factor analysis; and (b) that it is valid with respect to content validity (CVI 87.3%), concurrent validity (Pearson's r correlations ranging from -.67-.80 on the London Psychogeriatric Rating Scale [LPRS], and from -.76-.85 on the Functional Assessment Stages Scale [FAST]), and construct validity with significant differences between subjects with and without CI (t values ranging from 5.13-9.30). The AAI is a reliable and valid instrument that can be used to provide assessment data.
OBJECTIVE: To evaluate district nurses' management of leg ulcer patients and the effects of an in-service education programme led by district nurses as local educators at primary health-care centres. METHOD: Data were collected from electronic patient records (EPRs), both before and after the educational intervention. Nineteen district nurses undertook a one-day course focusing on four themes: Doppler assessment and measurement of ankle brachial pressure index; compression treatment; patient education; nursing documentation. Fourteen acted as in-service educators; 12 educators completed the intervention.The EPRs were scrutinised with an audit tool. RESULTS: The documentation on the selected key areas for the management of patients with leg ulcers was generally sparse, although the educational intervention resulted in statistically significant effects on documentation in three areas. CONCLUSION: Further improvements in care are necessary, as are qualitative and quantitative studies to explore the large discrepancies between guidelines and everyday clinical practice in this field.
The Mini-Mental State Examination (MMSE), as developed by Folstein, Folstein, and McHugh (1975), is the most widely used of cognitive screening tools. An examination of the psychometric properties of the MMSE seems warranted because the accurate and comprehensive assessment of mental status can yield profound implications for the quality of life of cognitively impaired older adults (Danner, Beck, Heacock, & Modlin, 1993). In clinical practice, nurses must not only use a valid and reliable screening tool for assessing cognitive impairment, but they must also assess the physical disabilities that may affect client performance and, hence, the cognitive impairment score. The purpose of this study is to examine the psychometric properties of the MMSE in comparison to a more standardized tool and to identify implications of the tool for clinical practice.
AIM: to explore and describe the student midwife's experiences in offering continuous labour support. DESIGN: a qualitative research design was chosen. Each student midwife offered continuous labour support to five women/couples and wrote narratives about each of these occasions. Written narratives from 11 student midwives were analysed using qualitative content analysis. FINDINGS: when student midwives offer continuous labour support to women/couples, they try to establish rapport. When this works, their presence, their sense of confidence and their ability to offer reassurance increase. If establishing rapport does not work, students experience a sense of powerlessness, a need for reassurance and a lack of confidence. KEY CONCLUSIONS: offering continuous labour support to women and/or their partners made the students aware of the importance of establishing rapport, and it made them realise the impact that their mere presence in the room could have. The students had a need for reassurance which could hamper their efforts to establish rapport. Experiencing a lack of confidence made students focus more strongly on their clinical skills and on their perceived role as a student midwife. IMPLICATIONS FOR PRACTICE: this study can initiate discussions about how student midwives learn to be supportive, as well as about the role models that students encounter during their clinical training in Sweden.
The aims of the study were to investigate the risk for and prevalence of pressure ulcers in different medical care groups, to discover if patients at risk for or with pressure ulcers are allocated appropriate pressure ulcer preventions and to investigate which variables are associated with appropriate pressure ulcer preventions. A cross-sectional survey design was used and followed the methodology developed by the European Pressure Ulcer Advisory Panel. A total of 612 patients participated in the study. The prevalence of pressure ulcers was greatest in geriatric care, followed by intensive care, acute care and neurological care. The majority of patients at risk for or with pressure ulcers did not receive appropriate preventative measures, either while they were in bed or in a chair. Significant variables associated with appropriate preventions in bed were intensive care, geriatric care, a low Braden score, a low score in the subscale activity and a long hospital stay.
A non-random sample of 331 community-based clients aged 75 years and over, who were being cared for at home, were involved in a longitudinal study to assess cognitive impairment (CI). The clock drawing test (CDT) using the Watson et al (1993) scoring protocol was used to determine its utility as a tool for community nurses to assess CI. In the first phase of the study, 294 CDTs were used in analysis and 58.8% (n = 172) of participants were cognitively impaired. Subsequent assessments at 9 months and 18 months using both the CDT and the Mini-Mental State Examination (MMSE) confirmed the high initial level of cognitive impairment among the sample. Over the course of the study 37 participants who had high CDT scores were admitted to institutional care and their cognitive status continued to decline. Among those who remained in the community, the percentage with some degree of cognitive impairment remained high, and over the course of the study there was a significant linear decline in the mean MMSE score. The CDT takes less time to administer than the MMSE and appears to be a more sensitive tool for detecting early changes in cognition. The CDT could therefore be useful as an initial assessment tool by community mental health nurses to help facilitate early intervention for older clients who are beginning to experience cognitive changes.
The purpose of this study was to refine the Western Consortium for Cancer Nursing Research (WCCNR) stomatitis staging system. Fifty-six adult cancer patients were accrued. Using all eight descriptors, 96.4% of the participants were correctly staged. Using only lesions, colour and bleeding, however, 92.9% of the cases were correctly staged. Based on the findings of this study, the WCCNR stomatitis staging system has been shortened to include only lesions, colour and bleeding.