RESUMEN
BACKGROUND: Incontinence is a common problem in long term care. In March 2003, in reviewing its performance on the Minimum Data Set (MDS 3.0) quality indicators, Sea View Hospital Rehabilitation Center and Home, a 304-bed long term care facility in Staten Island, New York, discovered it was 39% above the average of the state and national means for the incontinence indicators. In response, it initiated a facilitywide performance improvement project. METHODS: Processes identified in the action plan for the project, "Residents who trigger for occasional or frequent bowel and bladder incontinence on MDS will be assessed for an individualized toileting schedule," included (1) revision of assessment documentation, which improved the initial assessment of continence, with an added reassessment process; (2) documentation of the toileting plan on the Patient Care Technician Assignment Card and the Activity of Daily Living Accountability Sheet; (3) adoption of toilet-assist devices; (4) hospitalwide in-service on incontinence and toileting; and (5) revision of the bowel and bladder incontinence policy. RESULTS: After implementation of the revised bowel and bladder incontinence assessment tool, the rate of incontinence without a toileting plan decreased--from 79% to 38%--and remained below the yearly mean. DISCUSSION: The new assessment processes made individualized planning possible and accurate. This initiative could be easily replicated because it requires resources that are basic to most long term care facilities.
Asunto(s)
Incontinencia Fecal/prevención & control , Hogares para Ancianos , Casas de Salud , Control de Esfínteres , Incontinencia Urinaria/prevención & control , Anciano , Distinciones y Premios , Incontinencia Fecal/terapia , Humanos , Cuidados a Largo Plazo , Ciudad de Nueva York , Estudios de Casos Organizacionales , Centros de Rehabilitación , Incontinencia Urinaria/terapiaRESUMEN
Little attention has been directed towards identifying and addressing the psychosocial needs of ethnic minority and underserved cancer patients. This study describes the development of a psychosocial needs survey and patterns and predictors of need among an ethnically diverse underserved cancer patient population in Bronx, New York. A 34-item psychosocial needs assessment survey was developed to assess 4 categories of need: Informational, Practical, Supportive, and Spiritual. A total of 248 oncology outpatients (48% non-Hispanic whites, 25% African Americans; 19% Hispanic) completed the survey in oncology clinic waiting rooms. The survey demonstrated high internal consistency and face validity. Ethnicity was the sole predictor of needs (P < .02), even after controlling for education, time since diagnosis, treatment status, marital status, and age. The mean percentage of needs endorsed by African Americans, Hispanics, and non-Hispanic whites respectively was 81%, 85%, 70% for Informational; 63%, 68%, 36% for Practical; 69%, 73%, 48% for Supportive; and 49%, 60%, 31% for Spiritual needs. This needs assessment offers clear directions in which to focus QOL intervention efforts among underserved and ethnic minority cancer patients. Cancer 2007. (c) 2006 American Cancer Society.
Asunto(s)
Negro o Afroamericano , Hispánicos o Latinos , Indígenas Norteamericanos , Evaluación de Necesidades , Neoplasias/psicología , Apoyo Social , Población Blanca , Femenino , Humanos , Masculino , Neoplasias/etnologíaRESUMEN
BACKGROUND: In this article, we evaluate adoption of cancer education into the mandatory in-service training of home health attendants (HHA) comprised predominantly of African American and Hispanic women. METHODS: Three home health care training agencies in Bronx, NY, incorporated cancer prevention and outreach education into HHA training. RESULTS: Across 3 years, 87% (n = 2513) of HHAs received the intervention and disseminated it to 1600 clients/family/friends. HHAs reported high program satisfaction (98%) and interest (82%) in cancer outreach. Agency staff reported more benefits than costs to implementation. CONCLUSIONS: The home health care training agency appears an accessible and effective bridge for disseminating cancer education to the underserved.
Asunto(s)
Educación en Salud , Agencias de Atención a Domicilio , Auxiliares de Salud a Domicilio/educación , Neoplasias , Evaluación de Programas y Proyectos de Salud , Actitud del Personal de Salud , Agencias de Atención a Domicilio/organización & administración , Humanos , Capacitación en Servicio , Ciudad de Nueva YorkRESUMEN
BACKGROUND: This study assessed cancer knowledge, attitudes, beliefs, and practices (KABP) among 1,280 African American and Hispanic women. METHODS: A written self-report KABP survey was administered. RESULTS: Most women reported using breast self-examination (BSE), clinical breast examination (CBE), and mammography, but only 66% had had Pap tests in the preceding year. Group comparisons revealed significant differences for cancer and disease beliefs between the Black and the Hispanic women. Less knowledge about screening significantly predicted underutilization of Pap testing (OR = 2.71, CI 2.02, 3.63), BSE (OR = 1.63, CI 1.63, 2.13), and CBE (OR = 1.66, CI 1.27, 2.18). CONCLUSIONS: KABP surveys were important in developing cancer interventions.