Journal of the American Academy of Nurse Practitioners
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J Am Acad Nurse Pract · May 2009
The effects of nurse practitioner cultural competence on Latina patient satisfaction.
To explore the relationship between degree of cultural competence in nurse practitioners (NPs) and measures of patient satisfaction among Latinas. ⋯ The provision of culturally competent care leads to negotiation, mutual exchange of information, increased compliance, and improved patient-provider communication. Similarly, patient satisfaction with care is associated with increased compliance and greater continuity of care. Employers seeking to meet the healthcare demands of a growing Latino population must look at extrinsic values such as NPs' certification, cultural competence training, education, and ability to speak Spanish.
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J Am Acad Nurse Pract · Mar 2009
The prevalence of impaired glucose metabolism in Hispanics with two or more risk factors for metabolic syndrome in the primary care setting.
The purposes of this observational prospective study were (a) to identify the prevalence of undiagnosed impaired glucose metabolism (IGM) including impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes mellitus (T2DM) in 55 Hispanic subjects with two or more risk factors for the metabolic syndrome, (b) to examine the association between glucose metabolism and cardiometabolic risk factors (CMRF), including metabolic syndrome components, and (c) to identify predictors of IGM. ⋯ The prevalence of IGM is extremely high in Hispanics with metabolic syndrome. Screening for IGM with fasting blood glucose alone underestimates the prevalence of IGM in this population. In subjects with multiple CMRF, screening at lower levels of BMI is warranted.
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J Am Acad Nurse Pract · Mar 2009
Comparative StudyThe advance directive prevalence in long-term care: a comparison of relationships between a nurse practitioner healthcare model and a traditional healthcare model.
The purpose of this study was to examine rates of completion of advance directives (ADs) among institutionalized older adults in three geographically diverse areas of the country--Arizona, Georgia, and Massachusetts. Comparisons among four variables--gender, race, education, and type of healthcare model (Evercare vs. non-Evercare), related to AD completion rates were examined. ⋯ With the increasing number of older adults in the general and the long-term care population, older adults should be encouraged to complete their ADs when discussing their medical decisions with their healthcare providers. Through the use of the Evercare healthcare model, NPs are well prepared to assist their clients and families in identifying these decisions. As a result, a significantly greater proportion of ADs have been completed by individuals enrolled in the Evercare healthcare model when compared to non-Evercare individuals living in long-term care settings. By using this model, Evercare NPs ensure that the specific medical choices of their patients are carried out.
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J Am Acad Nurse Pract · Feb 2009
ReviewInterventions for promoting mobility in community-dwelling older adults.
The purposes of this review were to provide an updated report of intervention studies designed to enhance mobility in older adults and discuss the strengths and limitations of existing intervention studies and their implications for practice. ⋯ Prescribing regular physical activity including aerobic exercise and resistance training in a primary care setting can be a beneficial approach to minimize progression of impaired mobility in older adults. The typical dose of the physical activity prescription is 20-60 min of aerobic activity three times weekly. Adherence to mobility enhancement recommendations by older patients can be followed up by in-person interview or use of mobility monitoring tools such as exercise diary or log.