자연주의적 탐구조사(Naturalistic Inquiry)

The Statistics of Canada

Informed Consent. Legal Theory and Clinical Practice

Downloading the book in this website lists can give you more advantages. It will show you the best book collections and completed collections. So many books can be found in this website. So, this is not only this ethnography in nursing research. However, this book is referred to read because it is an inspiring book to give you more chance to get experiences and also thoughts. This is simple, read the soft file of the book and you get it.

Ethnography in Nursing Research

Arterial hypertension represents a major global health concern; more than one fourth of the population is affected by high blood pressure Albeit the underlying cause of the disease remains unclear in the vast majority of the cases, ~10% are of secondary origin Endocrine disorders are common illnesses and some of them may lead to elevated blood pressure, among which thyroid diseases are of high prevalence and often overlooked, especially in mild cases Overt and subclinical hyper- and hypothyroidism can both lead to (mostly mild) hypertension; however, the underlying mechanisms are only partially understood The results of clinical studies are often controversial During the past decades, some genetic mutations in the hypothalamus-pituitary-thyroid axis with cardiovascular consequences were revealed Atherosclerotic changes resulting from lipid abnormalities due to thyroid dysfunction also affect the vasculature and can cause elevated blood pressure The review gives a synopsis of our knowledge how thyroid hormone metabolism and functional thyroid diseases affect the cardiovascular system, their negative impact and causative role in the development of hypertension

Hypertension in Thyroid Disorders

Most patients with hypertension have no clear etiology and are classified as having primary hypertension However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause The prevalence and potential etiologies of secondary hypertension vary by age The most common causes in children are renal parenchymal disease and coarctation of the aorta In adults 65 years and older, atherosclerotic renal artery stenosis, renal failure, and hypothyroidism are common causes Secondary hypertension should be considered in the presence of suggestive symptoms and signs, such as severe or resistant hypertension, age of onset younger than 30 years (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings Additionally, renovascular hypertension should be considered in patients with an increase in serum creatinine of at least 50% occurring within one week of initiating angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy; severe hypertension and a unilateral smaller kidney or difference in kidney size greater than 15 cm; or recurrent flash pulmonary edema Other underlying causes of secondary hypertension include hyperaldosteronism, obstructive sleep apnea, pheochromocytoma, Cushing syndrome, thyroid disease, coarctation of the aorta, and use of certain medications

Secondary Hypertension: Discovering the Underlying Cause

Purpose of the Study The purpose of this study was to describe the experiences and challenges of supporting family caregivers of seniors with complex needs and to outline support strategies and research priorities aimed at supporting them. Design and Methods A CIHR-funded, two-day conference entitled “Supporting Family Caregivers of Seniors: Improving Care and Caregiver Outcomes” was held. An integrated knowledge translation approach guided this planning conference. Day 1 included presentations of research evidence, followed by participant engagement Qualitative data was collected regarding facilitators, barriers/gaps, and recommendations for the provision of caregiver supports. Day 2 focused on determination of research priorities. Results Identified facilitators to the provision of caregiver support included accessibility of health-care and community-based resources, availability of well-intended health-care providers, and recognition of caregivers by the system. Barriers/gaps related to challenges with communication, access to information, knowledge of what is needed, system navigation, access to financial resources, and current policies. Recommendations regarding caregiver services and research revolved around assisting caregivers to self-identify and seek support, formalizing caregiver supports, centralizing resources, making system navigation available, and preparing the next generation for caregiving. Implication A better understanding of the needs of family caregivers and ways to support them is critical to seniors’ health services redesign.

/pdf/understanding-how-to-support-family-caregivers-of-seniors-1sqoiekhvk.pdf

Understanding How to Support Family Caregivers of Seniors with Complex Needs.

Support for family caregivers: A scoping review of family physician’s perspectives on their role in supporting family caregivers

Background Decision-making capacity assessment (DMCA) is an issue of increasing importance for older adults. Current challenges need to be explored, and potential processes and strategies considered in order to address issues of DMCA in a more coordinated manner. Methods An iterative process was used to address issues related to DMCA. This began with recognition of challenges associated with capacity assessments (CAs) by staff at Covenant Health (CH). Review of the literature, as well as discussions with and a survey of staff at three CH sites, resulted in determination of issues related to DMCA. Development of a DMCA Model and demonstration of its feasibility followed. Results A process was proposed with front-end screening/problemsolving, a well-defined standard assessment, and definition of team member roles. A Capacity Assessment Care Map was formulated based on the process. Documentation was developed consisting of a Capacity Assessment Process Worksheet, Capacity Interview Worksheet, and a brochure. Interactive workshops were delivered to familiarize staff with the DMCA Model. A successful demonstration project led to implementation across all sites in the Capital Health region, and eventual provincial endorsement. Conclusions Concerns identified in the survey and in the literature regarding CA were addressed through the holistic interdisciplinary approach offered by the DMCA Model.

https://www.cgjonline.ca/index.php/cgj/article/download/142/226

The Development and Implementation of a Decision-Making Capacity Assessment Model

Background There is a growing mandate for Family Medicine residency programs to directly assess residents’ clinical competence in Care of the Elderly (COE). The objectives of this paper are to describe the development and implementation of incremental core competencies for Postgraduate Year (PGY)-I Integrated Geriatrics Family Medicine, PGY-II Geriatrics Rotation Family Medicine, and PGY-III Enhanced Skills COE for COE Diploma residents at a Canadian University. Methods Iterative expert panel process for the development of the core competencies, with a pre-defined process for implementation of the core competencies. Results Eighty-five core competencies were selected overall by the Working Group, with 57 core competencies selected for the PGY-I/II Family Medicine residents and an additional 28 selected for the PGY-III COE residents. The core competencies follow the CanMEDS Family Medicine roles. Both sets of core competencies are based on consensus. Conclusions Due to demographic changes, it is essential that Family Physicians have the required skills and knowledge to care for the frail elderly. The core competencies described were developed for PGY-I/II Family Medicine residents and PGY-III Enhanced Skills COE, with a focus on the development of geriatric expertise for those patients that would most benefit.

/pdf/geriatric-core-competencies-for-family-medicine-curriculum-16kynal8qj.pdf

Lesley Charles

Papers

Secondary Hypertension: Discovering the Underlying Cause

Understanding How to Support Family Caregivers of Seniors with Complex Needs.

Support for family caregivers: A scoping review of family physician’s perspectives on their role in supporting family caregivers

The Development and Implementation of a Decision-Making Capacity Assessment Model

Geriatric Core Competencies for Family Medicine Curriculum and Enhanced Skills: Care of Elderly