Contemp Nurse
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Few health professionals feel confident and comfortable when communicating with patients about the sexual and intimate changes that might occur after a diagnosis of cancer. Little research has focused on why health professionals find this type of patient communication so challenging. Drawing on data from a larger study examining issues of intimacy and sexuality from the perspectives of patients and health professionals in cancer and palliative care, this paper will present the health professional perspective. ⋯ Many unchecked assumptions about patient sexuality were made by health professionals, based on the patient's age, diagnosis, culture, partnership and disease status. It was personally confronting and a 'risky' business to communicate about issues of patient intimacy and sexuality after cancer, particularly when the clinical setting emphasised medicalised, health professional driven and problem-based communication. Implications for practice will be discussed.
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Delirium remains a commonly occurring problem for older people and staff in acute care settings. The aim of this review of current literature is to find contemporary evidence on which to base practice modalities. Although the literature provides an exposition of the concerns with which practitioners are currently faced and highlights the consistent themes identified, there is little research evidence regarding the effectiveness of treatment protocols for the management of older people with delirium in acute care setting.
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That the population is ageing poses many challenges for health care planners. Some argue that these challenges, exacerbated by limited funding, maintaining increased community expectations and the need for quality health care outcomes, may be overcome by exploring alternate models of care. These ideas have led health planners to reconceptualise contemporary philosophies of care with the current emphasis on multidisciplinary teams and a person-centred approach to care. ⋯ In the model the care of older people is underpinned by a philosophy of person-centredness. The complex nature of care is represented along with those factors that enable a person-centred approach to be taken. The functions of the model in practice are highlighted and discussion of how it is being implemented within the acute care sector outlined.
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Canada, like many countries, is in the midst of primary health care reform. A key priority is to improve access to primary health care, especially in remote communities and areas with physician shortages. ⋯ As of March 2006, legislation exists in all provinces and two territories in Canada that allows nurse practitioners (NPs) to implement their expanded nursing role. In this paper, we will briefly review the historical development of the NP role in Canada and situate it in the international context; describe the NP role, supply of NPs in the country, and the settings in which they work; propose an NP practice model framework; summarize facilitators and barriers to NP role implementation in primary health care delivery; and outline strategies to address the barriers.
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Thailand supports a system of universal health care coverage and promotes a system of primary care. Effective and efficient primary health care can improve health through increasing access and thereby reducing inequities. Nurses are key providers of primary care services, particularly in remote areas and play an important role in improving the health and well-being of the Thai community.