Clinical Nurse Specialist 

About: Clinical Nurse Specialist is an academic journal published by Lippincott Williams & Wilkins. The journal publishes majorly in the area(s): Clinical nurse specialist & Health care. It has an ISSN identifier of 0887-6274. Over the lifetime, 2027 publications have been published receiving 20862 citations. The journal is also known as: CNS & Clin Nurse Spec.

The Practical Guide to the Identification, Evaluation and Treatment of Overweight and Obesity in Adults

Abstract: ACKNOWLEDGMENTS: The Working Group wishes to acknowledge the additional input to the Practical Guide from the following individuals: Dr. and Blood Institute's (NHLBI) Obesity Education Initiative in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The impetus behind the clinical practice guidelines was the increasing prevalence of overweight and obesity in the United States and the need to alert practitioners to accompanying health risks. The Expert Panel that developed the guidelines consisted of 24 experts, 8 ex-officio members, and a consultant methodologist representing the fields of primary care, clinical nutrition, exercise physiology, psychology, physiology, and pulmonary disease. and Treatment of Overweight and Obesity in Adults is largely based on the evidence report prepared by the Expert Panel and describes how health care practitioners can provide their patients with the direction and support needed to effectively lose weight and keep it off. It provides the basic tools needed to appropriately assess and manage overweight and obesity. The guide includes practical information on dietary therapy, physical activity, and behavior therapy, while also providing guidance on the appropriate use of pharmacotherapy and surgery as treatment options. The Guide was prepared by a working group convened by the North American Association for the Study of Obesity and the National Heart, Lung, and Blood Institute. Three members of the American Society for Bariatric Surgery also participated in the working group. Members of the Expert Panel, especially the Panel Chairman, assisted in the review and development of the final product. Special thanks are also due to the 50 representatives of the various disciplines in primary care and others who reviewed the preprint of the document and provided the working group with excellent feedback. The Practical Guide will be distributed to primary care physicians, nurses, registered dietitians, and nutritionists as well as to other interested health care practitioners. It is our hope that the tools provided here help to complement the skills needed to effectively manage the millions of overweight and obese individuals who are attempting to manage their weight. Foreword vi O verweight and obesity, serious and growing health problems, are not receiving the attention they deserve from primary care practitioners. Among the reasons cited for not treating overweight and obesity is the lack of authoritative information to guide treatment. the NHLBI Expert Panel and released in June 1998. The Expert Panel used an evidence-based methodology to develop key recommendations for …

Content analysis: process and application.

Abstract: Content analysis is a research method for analyzing written verbal or visual communication messages. When appited to messages produced in clinical settings, content analysis is a relevant strategy for conducting practice-oriented nursing research.In this paper content analysis is defined and the bas

Integrated Theory of Health Behavior Change: background and intervention development.

Abstract: An essential characteristic of advanced practice nurses is the use of theory in practice. Clinical nurse specialists apply theory in providing or directing patient care, in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. In this article, the Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented. The Integrated Theory of Health Behavior Change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation. Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation. Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care.

Perceived readiness for hospital discharge in adult medical-surgical patients.

Abstract: : Purpose : The purpose of the study was to identify predictors and outcomes of adult medical-surgical patients’ perceptions of their readiness for hospital discharge. Design : A correlational, prospective, longitudinal design with path analyses was used to explore relationships among transition theory-related variables. Setting : Midwestern tertiary medical center. Sample : 147 adult medical-surgical patients. Methods : Predictor variables included patient characteristics, hospitalization factors, and nursing practices that were measured prior to hospital discharge using a study enrollment form, the Quality of Discharge Teaching Scale, and the Care Coordination Scale. Discharge readiness was measured using the Readiness for Hospital Discharge Scale administered within 4 hours prior to discharge. Outcomes were measured 3 weeks postdischarge with the Post-Discharge Coping Difficulty Scale and self-reported utilization of health services. Findings : Living alone, discharge teaching (amount of content received and nurses’ skill in teaching delivery), and care coordination explained 51% of readiness for discharge score variance. Patient age and discharge readiness explained 16% of variance in postdischarge coping difficulty. Greater readiness for discharge was predictive of fewer readmissions. Conclusions : Quality of the delivery of discharge teaching was the strongest predictor of discharge readiness. Study results provided support for Meleis’ transitions theory as a useful model for conceptualizing and investigating the discharge transition. Implications for Practice : The study results have implications for the CNS role in patient and staff education, system building for the postdischarge transition, and measurement of clinical care outcomes. With the contemporary focus on minimizing length of hospital stay, patients are discharged in an intermediate rather than complete stage of recovery.

Depression in Hospital-Employed Nurses

Abstract: Depression impacts 9.4% of the adult population in the United States, and it is known to impact work performance. Nurses with depression are not only likely to suffer themselves, but their illness may have an impact on their coworkers and potentially the quality of care they provide. Thus, the purpose of this study was to determine the prevalence of depression in a random sample of hospital-employed nurses to determine individual and workplace characteristics that are associated with depression. A cross-sectional survey design of 1171 registered nurses was used. Measures included individual characteristics, workplace characteristics, work productivity, and depression (9-item Patient Health Questionnaire). Data analysis demonstrated a depressive symptom rate of 18%. The linear regression model accounted for 60.6% of the variation in the 9-item Patient Health Questionnaire depression scores. Body mass index, job satisfaction, number of health problems, mental well-being, and health-related productivity had significant relationships with depression (P < .05). Hospital-employed nurses have higher rates of depressive symptoms than national norms. Advanced practice nurses can assist with educating nurses on recognizing depression and confidential interventions, including the use of computerized cognitive-based therapy.