Psychiatric nursing & medication adherence

A survey was developed to determine whether the rapidly changing context of mental health care has significantly influenced how psychiatric nurses assess and intervene in issues related to medication adherence. A sample of 126 psychiatric nurses working in Veterans Affairs mental health treatment facilities in northern California, Hawaii, and Nevada identified the most effective methods for tracking medication adherence, as well as successful adherence interventions. Despite the challenge imposed by changing work environments, psychiatric nurses use creative and innovative approaches to improve their patients' medication adherence. Interventions for enhancing patient adherence with prescribed regimens are identified. Essential role dimensions related to medication adherence defined by the nurses in this survey included providing medication education, tracking patient adherence, assessing medication effectiveness, providing individualized, tailored adherence interventions, and collaborating with other health care providers in medication planning. Study findings support using nurses to their full potential and highlight nurses' need for more educational opportunities and consultation with experts (e.g., clinical pharmacists).     

Psychiatric nursing recruitment. Roles for educators and nursing staff

Recruiting new nurses to a relatively unpopular specialty in the midst of a nursing shortage is challenging. However, the literature offers educators and clinical nursing staff important insight regarding the promotion of student interest in psychiatric nursing. Clearly, a collaborative effort is needed. Educators and clinicians should work together to provide students with a satisfying psychiatric nursing experience. Through a combination of effective, intellectually stimulating classroom instruction and positive, welcoming clinical experiences, educators and clinical nursing staff may increase the number of nursing graduates who pursue this rewarding specialty.     

Food Aid in the 1990s

Book reviewed in this article: Food Aid Reconsidered: Assessing the Impact on Third World Countries. Edited by Edward Clay and Olav Stokke     

Psychiatric mental health consultation and nursing in the United Arab Emirates.

1. Our "mission" was preparing psychiatric services for the anticipated high number of allied casualties; providing clinical, educational, and developmental support to the host nation; and maintaining diplomatic relations within the hospital and surrounding community. 2. Because of cultural differences, the hospital staff were uneasy about some of the inservice classes. US staff were taught the importance of refusing to succumb to "the illusion of color blindness." 3. With the support of the host, we took leadership in receiving and training the casualties of the war. Psychiatric services were provided to allied troops as well as the citizens of Dubai.     

Psychiatric nurses' attitudes toward and involvement in nursing research.

1. The three major blocks to clinical nursing research are lack of time, knowledge, and administrative support. 2. Positive attitudes toward nursing research were found to be related to nurses' advanced levels of education. 3. Two strategies to foster the development of research skills are inservice education classes and individualized guided learning experiences. 4. Two essential resources for staff who are expected to engage in clinical research activities are statistical consultation and clerical services.     

Psychiatric nursing for the 21st century. The PACED model.

Health care reform has had a profound effect on the way psychiatric treatment occurs in this country. Decreasing length of stay, increasing acuity, and reducing staff levels are making traditional approaches to mental health care infeasible. Resources already in place may still be focusing on long-term treatment issues and do not facilitate rapid stabilization and discharge planning that includes continued care within an integrated system. Research supports the feasibility of quality mental health care, which can be accomplished in shortened lengths of stay, as long as clinical managers plan inpatient programs focused on short-term goals followed by appropriate aftercare. In addition to recommendations for clinical managers, this article provides a proposal for executives redesigning a mental health care delivery system, which includes the goals of rapid assessment and stabilization, as well as discharge planning and appropriate follow up within an integrated system.     

Family-Centered Practice in the 1990s:

This paper presents a multicultural perspective for family-centered social work practice. Such a perspective uses ethclass and value orientation theory as sensitizing conceptual frameworks for understanding a family's cultural reality. This understanding, used by a multicultural practitioner, leads to the use of approaches most congruent with the multicultural world views of the families served.     

Children of Divorce in the 1990s

Abstract

Amato and Keith's (1991) comprehensive meta-analysis of well-being differences in children from divorced and intact families found that, when studies were divided by era (1950-1969, 1970-1979, and 1980-1989), the apparent decrements to children of divorce became smaller over time. In an attempt to replicate and extend the Amato and Keith meta-analysis, we conducted a similar one for the 1990s, drawing from 35 published articles. Results showed that across several domains of child well-being (school achievement, conduct, psychological adjustment, self-concept, social adjustment, mother-child relations, and father-child relations), decrements to children of divorce between 1990-1999 were slightly-though consistently-more pronounced than in the previous decade.     

Work and Family in the 1990s

This review highlights four themes emerging from the work and family literature of the 1990s. The first theme evolves from the historical legacy of the maternal employment literature with its focus on children's well‐being. The second theme, work socialization, is based on the premise that occupational conditions, such as autonomy and complexity, shape the values of workers who in turn generalize these lessons off the job. Research on work stress, the third theme, explores how experiences of short‐ and long‐term stress at work make their mark on workers' behavior and well‐being off the job. Finally, the multiple roles literature focuses on how individuals balance roles, such as parent, spouse, and worker, and the consequences for health and family relationships. In addition to these four major themes, advances in work and family policy initiatives over the past decade are discussed. Suggestions for future research focus on addressing issues of causality, attending to the complexity of social contexts, linking research to policy, and developing interdisciplinary theories and research designs.     

The dynamics of the U.S. occupational structure during the 1990s

During the 1990s, the U.S. economy experienced dramatic structural changes, such as the decline in the defense industry following the end of the Cold War, an extraordinary amount of corporate restructuring and downsizing, a dramatic increase in computer usage in the workplace, the adoption of NAFTA, and the emergence of the global economy. These changes would lead one to expect fairly significant upheaval in the U.S. occupational structure. In fact, my findings indicate relatively remarkable stability of the U.S. labor market and its occupational structure. Moreover, many of the changes which have occurred have been beneficial. I thank an anonymous referee for helpful comments. I also thank Steven Hippie, Jay Meisenheimer, and Tiffany Stringer of the Bureau of Labor Statistics of the U.S. Department of Labor for providing some of the data for this study, as well as insight into their appropriate interpretation and use. Research support provided by Dowling College is gratefully acknowledged. The author assumes responsibility for any errors or omissions.     

Resurgent Irish immigration to the U.S. in the 1980s and early 1990s: a socio-demographic profile

Irish immigration to the US has been motivated traditionally by a lack of employment opportunities at home. With the passage of the US Immigration and Nationality Act of 1965, however, Irish immigrants were no longer explicitly favoured. Family reunification became the primary path of entry, which worked against the Irish who had lost their immediate generational link with US residents.
During the severe Irish recession of 1980–85 a resurgence in Irish outflows resulted in a large undocumented Irish population in the US. Most of this population was later legalized as a result of special legislation that targeted the Irish. There have been concerns in Ireland that the outflow in the 1980s, unlike prior flows, included a high proportion of skilled persons, leading some to characterize the outflow as a "new wave".
This article uses US immigration data to assess how the occupational characteristics of recent Irish immigrants compare with prior immigrant cohorts and also examines how Irish immigrants are incorporated into the US economy.
Recent Irish immigrants to the US spanned the occupational spectrum: accountants, engineers, nurses and other professionals found a booming job market in the most advanced sectors of the US economy, while less skilled immigrants found jobs in the informal economy. While the number of entering Irish professionals increased, flows of the less skilled increased even more dramatically, resulting in an overall decline in the occupational selectivity of Irish immigrants.
The 1980–85 Irish recession has been followed by robust growth for more than a decade. Ireland is now experiencing a net inflow of persons, including many Irish professionals returning from the US. However, Ireland continues to experience a net outflow of the young and less skilled which may once again result in a large undocumented Irish presence in the US.     

The American sociologist: Characteristics in the 1990s

This article describes the characteristics, theoretical preferences, and political orientations of sociologists in the United States. The findings are the most representative of their kind reported to date. Other professional groups, such as psychiatrists, have been studied over time (Gallagher, 1977; Gallagher et al., 1987; Gallagher et al., 1990), but studies of sociologists have been almost non-existent. In fact, there has only been one study of this nature conducted in the 1990s, and that one sampled only sociologists whose names appeared on the membership list of the American Sociological Association (Sanderson and Ellis, 1992). However, that sampling frame did not provide a representative cross-section of American sociologists because it excluded the large proportion of sociologists who are not members of the ASA and who probably are systematically different than members. It is ironic that sociologists who intensively study the characteristics of all sorts of groups know so little about themselves. That is a major reason why this project was undertaken.     

Scholarship on Fatherhood in the 1990s and Beyond

Throughout the 1990s, scholars interested in fatherhood have generated a voluminous, rich, and diverse body of work. We selectively review this literature with an eye toward prominent theoretical, methodological, and substantive issues. This burgeoning literature, complemented by social policy makers' heightened interest in fathers and families, focuses on fatherhood in at least 4 key ways. First, theorists have studied fatherhood as a cultural representation that is expressed through different sociocultural processes and embedded in a larger ecological context. Second, researchers have conceptualized and examined the diverse forms of fatherhood and father involvement. Third, attempts have been made to identify the linkages between dimensions of the father‐child relationship and developmental outcomes among children and fathers. Fourth, scholars have explored the father identity as part of a reciprocal process negotiated by men, children, mothers, and other interested parties. Our review highlights research that examines the relationships between dimensions of the father‐child relationship and children's well‐being and development. We conclude by discussing promising avenues of scholarship for the next generation of research on fatherhood.