ANS. Advances in nursing science
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Collective violence leads to grievous harm for affected populations, impacting both combatants and noncombatants. In recent years there has been an increased focus on the relationship between peace and health, with the World Health Organization calling for health professionals to engage in efforts to promote peace. While the notion of "health as a bridge for peace" is promising, there are many ambiguities in this emerging field, creating moral and practical dilemmas. In this manuscript I will discuss some of the challenges within the paradigm of health and peace using an exemplar of my research within the Israeli-Palestinian conflict.
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Secondary analysis of data from 2 studies examining palliative care in rural areas was conducted with the aim to better understand how a nursing palliative approach influences quality outcomes at end-of-life. Nurses' ways of being that brought connection and comfort at end-of-life included paying attention to time, privacy, and family support. The rural context with its geography, relationships, and unique resources influenced nurses' abilities to enact a palliative approach. Findings demonstrate that urban-centric models of palliative care do not fit well in rural nursing practice and highlight the importance of understanding the rural context.
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Nearly 50% of adults have one or more chronic illnesses. Self-care is considered essential in the management of chronic illness, but the elements of self-care in this context have not been specified in a middle-range theory. ⋯ Assumptions and propositions of the theory are specified. Factors influencing self-care including experience, skill, motivation, culture, confidence, habits, function, cognition, support from others, and access to care are described.
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The rising population of older Americans with advanced illness challenges current care delivery models. We use the metaphor of advanced illness as a difficult journey and propose a specific role, that of the "OACIS NP [nurse practitioner]," who helps provide a place of refuge during this journey. "OACIS" is an acronym for Optimizing Advanced Complex Illness Support, a program to provide home-based palliative medical care. The 4 pillars of this collaborative model for advanced nursing care include care coordination, medical management, psychosocial support, and education. We make the case for this expanded role for nurse practitioners who specialize in palliative care.