자연주의적 탐구조사(Naturalistic Inquiry)

Much has been written about theory and practice in the law, and the tension between practitioners and theorists. Judges do not cite theoretical articles often; they rarely "apply" theories to particular cases. These arguments are not revisited. Instead the Essay explores the working and interaction of theory and practice, practitioners and theorists. The Essay starts with a story about solving a legal issue using our intellectual tools - theory, practice, and their progenies: experience and "gut." Next the Essay elaborates on the nature of theory, practice, experience and "gut." The third part of the Essay discusses theories that are helpful to practitioners and those that are less helpful. The Essay concludes that practitioners theorize, and theorists practice. They use these intellectual tools differently because the goals and orientations of theorists and practitioners, and the constraints under which they act, differ. Theory, practice, experience and "gut" help us think, remember, decide and create. They complement each other like the two sides of the same coin: distinct but inseparable.

Of Theory and Practice

On Symbolic Interactionism

Objective: to perform a systematic review of studies measuring the prevalence of elder abuse or neglect, either reported by older people themselves, or family and professional caregivers or investigated using objective measures. Methods: we conducted a comprehensive literature search of multiple databases up to October 2006, supplemented by a search of the references of all relevant articles. Validity of studies was graded by two authors independently using a standardised checklist. Results: forty-nine studies met our inclusion criteria, of which only seven used measures for which reliability and validity had been assessed. In the general population studies, 6% of older people reported significant abuse in the last month and 5.6% of couples reported physical violence in their relationship in the last year. In studies using valid instruments involving vulnerable elders, nearly a quarter reported significant levels of psychological abuse. Five per cent of family caregivers reported physical abuse towards care recipients with dementia in a year, and a third reported any significant abuse. Sixteen per cent of care home staff admitted significant psychological abuse. Rates of abuse recorded using objective measures (5%) or reported to home management or adult protective services (APS) (1‐2%) were low. Conclusion: one in four vulnerable elders are at risk of abuse and only a small proportion of this is currently detected. Elders and family and professional caregivers are willing to report abuse and should be asked about it routinely. Valid, reliable measures and consensus on what constitutes an adequate standard for validity of abuse measures are needed.

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The prevalence of elder abuse and neglect: a systematic review

Purpose Elder mistreatment is now recognized internationally as a pervasive and growing problem, urgently requiring the attention of health care systems, social welfare agencies, policymakers, and the general public. In this article, we provide an overview of global issues in the field of elder abuse, with a focus on prevention. Design and methods This article provides a scoping review of key issues in the field from an international perspective. Results By drawing primarily on population-based studies, this scoping review provided a more valid and reliable synthesis of current knowledge about prevalence and risk factors than has been available. Despite the lack of scientifically rigorous intervention research on elder abuse, the review also identified 5 promising strategies for prevention. Implications The findings highlight a growing consensus across studies regarding the extent and causes of elder mistreatment, as well as the urgent need for efforts to make elder mistreatment prevention programs more effective and evidence based.

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Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies

Objective: The objective of this research is to understand the experiences of homeless people with the health care system.

Design: A descriptive Phenomenological research design is used. Phenomenology is the philosophical underpinning of this research.

Sample: The purposive sample consists of 15 homeless adults.

Method: Interviews were conducted, tape-recorded, transcribed, and then analyzed the transcripts using Colaizzi's descriptive phenomenological method.

Results: 4 major themes emerged: (1) living without essential resources compromises health; (2) putting off health care until a crisis arises; (3) encountering barriers to receiving health care to include (a) social triage, (b) feeling labeled and stigmatized, (c) a nonsystem for health care for the homeless, (d) being treated with disrespect, and (e) feeling invisible to health care providers; and (4) developing underground resourcefulness.

Conclusions and Implications: Although homeless persons articulated many problems in the health care system encounters, they also described their own resourcefulness and the strategies they employ to manage being marginalized by society and the health care system. An increased understanding of health care experiences from the homeless persons' perspective can guide public health nursing emancipatory actions.

Experiences of homeless people in the health care delivery system: a descriptive phenomenological study.

A study of elder abuse in Korea

Historically, nursing students have questioned the value of a nursing research course and have not appreciated the research-practice link. These are important concerns in light of the increasing emphasis on evidence-based nursing practice. The purpose of this study was to develop innovative strategies for teaching undergraduate nursing research that engage millennial learners and emphasize the relationship between evidence-based practice and clinical outcomes. Innovative assignments were developed that included interactive learning, group work, and practical applications preferred by these learners. Using a Likert scale, students' perceived effectiveness of innovative assignments and more traditional assignments were compared. Results indicated a preference for active learning assignments, reading quizzes, clinical nurse researcher presentations, and collaboration with clinical course assignments. By combining traditional assignments with innovative strategies and nursing practice applications, millennial learners were engaged and able to clearly articulate the value of the research-practice link vital to evidence-based nursing practice.

Teaching undergraduate nursing research: a comparison of traditional and innovative approaches for success with millennial learners.

Throughout their history, symbolic interactionism and critical perspective have been viewed as divergent theoretical perspectives with different philosophical underpinnings. A review of their historical and philosophical origins reveals both points of divergence and areas of convergence. Their underlying philosophies of science and views of human freedom are different as is their level of focus with symbolic interactionism having a micro perspective and critical perspective using a macro perspective. This micro/macro difference is reflected in the divergence of their major concepts, goals and basic tenets. While their underlying philosophies are different, however, they are not necessarily contradictory and areas of convergence may include the concepts of reference groups and looking glass self within symbolic interactionism and ideological hegemony within critical perspective. By using a pragmatic approach and combining symbolic interactionism and critical perspectives, both micro and macro levels come into focus and strategies for change across individual and societal levels can be developed and applied. Application of both symbolic interactionism and critical perspective to nursing research and scholarship offers exciting new opportunities for theory development and research methodologies. In nursing education, these two perspectives can give students added insight into patients' and families' problems at the micro level while, at the same time, giving them a lens to see and tools to apply to problems at the macro level in health care. In nursing practice, a combined symbolic interactionism/critical perspective approach assists nurses to give high-quality care at the individual level while also working at the macro level to address the manufacturers of illness. New research questions emerge from this combination of perspectives with new possibilities for theory development, a transformation in nursing education, and the potential for new practice strategies that can address individual client and larger system problems through empowerment of clients and nurses.

Symbolic interactionism and critical perspective: divergent or synergistic?

Objective

The objective of this study was to examine the relationship between the nutritional status, incidence of food insecurity, and health risk among the homeless population in Rhode Island.



Design and Sample

This correlational study utilized a convenience sample of 319 homeless adults from Rhode Island's largest service agency for the homeless. Information on use of services such as access to emergency foods, shelters, and the Supplemental Nutrition Assistance Program (SNAP) was requested.



Measures

Food security was measured by the six-item subset of the USDA Food Security Core Module. Anthropometric measures included height, weight, and waist circumference. A 24-hr dietary recall was collected to determine the food intake for a subset of participants who agreed to supply this information (n = 197).



Conclusion

Average dietary recall data indicated insufficient intake of vegetables, fruit, dairy, and meats/beans. It also indicated excessive intake of fats. Of the 313 participants, 29.4% were overweight and 39% were obese. Over 94% of the participants were food insecure, with 64% of this subset experiencing hunger. Fifty-five percent of the participants were currently receiving SNAP benefits. The majority of the sample was found to be food insecure with hunger.

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Diane C. Martins

Papers

Experiences of homeless people in the health care delivery system: a descriptive phenomenological study.

A study of elder abuse in Korea

Teaching undergraduate nursing research: a comparison of traditional and innovative approaches for success with millennial learners.

Symbolic interactionism and critical perspective: divergent or synergistic?

Assessment of Food Intake, Obesity, and Health Risk among the Homeless in Rhode Island.