Health values最新文献

As part of the 1990 Health Objectives for the Nation Report, the Public Health Service (PHS) specified a 50% participation of older adults in aerobic activity. A review of national population based surveys indicated that older Americans are very unlikely to attain this objective. The authors' review of epidemiological and empirical literature, however, suggested that both high activity/high fitness and high activity/low fitness physical activities contribute to health. Moreover, the underlying dimension of the health goal for older Americans is to increase or maintain functional independence. Physical activities that emphasize flexibility, strength, and balance are essential components in maintaining activity in daily living skills for older Americans. A recommendation for cardiovascular health, based upon recent empirical studies, is that older adults should optimally attain a leisure time physical activity (LTPA) expenditure of 150 to 400 K-cal per day. The authors' analysis of the 1985 National Health Interview Survey; Health Promotion and Disease Prevention, indicated that only 22 percent of older Americans are attaining the minimal 150 K-cal threshold in LTPA. The authors subsequently argued that the physical fitness goal for older Americans should be revised to include not only aerobic activity but flexibility, strength, and balance.

This article discusses ethical decision-making within six hospital-based case management programs for the frail elderly. Ethical dilemmas are described within each of the following phases of the case management process: client identification, informed consent, assessment, service planning, service coordination/linking, and monitoring and evaluation. Implications for social workers as case managers are examined.

This study examined the status of health educators in Health Maintenance Organizations (HMOs). Specifically, the investigation described the utilization of health education personnel in HMOs, the way in which health education services were provided, and the effectiveness of health educators in HMOs as perceived by HMO administrators. Data from a national study showed that health educators were employed by all HMO types except Independent Practice Associations. Health education services tended to be provided in-house rather than through contractual services. HMO administrators were generally favorable toward the presence of health educators in their organizations and were satisfied with their performances, believing that they were cost effective and well educated for their position. The belief that health educators could be better utilized if they possessed additional skills apparently existed.

This study describes the health practices of nursing students from several nursing programs in western New York. Findings from a sample of 1,081 female students who responded to a questionnaire showed considerable variability in the extent to which students engage in health-related practices. While the majority obtain six to eight hours of sleep per night, exercise regularly, and have annual dental and physical examinations, less than half those surveyed eat breakfast everyday, over three-quarters eat between meals, and less than one-half limit fat, salt, and sugar in their diets. Most do not wear seat belts consistently; less than one-third perform breast self-examination monthly; and 90% consume alcoholic beverages and one-quarter have five or more drinks per occasion. Analyses demonstrated a statistically significant relationship between preventive-health orientation scores and age and type of basic nursing education. These data suggest that nurse faculty and health educators need to influence students' health-promoting and disease-preventing behaviors. This need is particularly salient since these students are expected to act as exemplars when they complete their education and assume positions in the health-care system.

This article examines women's participation in health-care delivery by reviewing dissimilarities in employment patterns of male and female health workers with primary emphasis on roles, status, and earnings. Selective data pertinent to gender-typing of jobs and the hierarchical structure of the health workforce are presented. Recent shifts in women's entry into health occupations are reviewed and questions are posed about prospects for change.

This article examines nursing home employee attitudes toward issues related to AIDS and is based on data collected from 343 employees from 13 nursing homes in rural, small towns in sourthern Illinois during the spring of 1988. Results suggested that a large majority of the employees had negative attitudes toward people with AIDS. For example, 67% of the sample indicated that it was more important to limit the spread of AIDS rather than to protect the rights of people with AIDS. Furthermore, 42% suggested that AIDS patients should be sent to sanitariums to protect others from AIDS. Greater than half of the sample (56%) responded that they would feel uncomfortable around people with AIDS. About one third (32%) felt that being around someone with AIDS would put their health in danger, and 21% would be afraid to even take care of a family member with AIDS. With regard to job-specific AIDS attitudes, 51% indicated that health-care workers should be able to refuse to work with AIDS patients, and another 46% felt that hospitals and nursing homes should be able to refuse to admit people with AIDS. In addition to these and other results, this article presents a brief discussion concerning possible educational strategies which might be implemented in this setting to reduce the negative attitudes of these employees. Considerations are also presented for nursing home administrators, who face the problem of developing effective policies for dealing with the rising number of AIDS patients who will be admitted to their facilities.

The purpose of this study was to determine the extent of corporate health-promotion program proliferation and propose a methodology to determine the effectiveness of these programs from a benefit to cost perspective. A national survey of firms sponsoring health-promotion activities was conducted. The specific goal of this study was to determine the extent to which firms were actually conducting financial analyses in order to determine whether their health-promotion programs were generating benefits that justified continued program funding. The results showed that although the concept of corporate health-promotion programs is popular, there is very little concern on the part of the sponsoring firms for measuring the effectiveness of their programs, particularly from a financial perspective. This suggests a vulnerability, as far as those programs are concerned. If such program costs cannot be justified on some quantifiable basis, the possibility of their cancellation seems rather likely if it becomes necessary to reduce expenditures.

Many worksite health-promotion projects only evaluate a program by documenting employee program utilization or by determining what behaviors have or have not been changed. The failure of a program may be due to its implementation rather than to the science of the intervention. Often, program implementation problems are overlooked. Many managers do not set up an implementation monitoring program to assess problems prior to breakdowns. This article describes how to monitor program implementation through the establishment of a Quality Assurance System in a worksite health-promotion program. A case study approach for a quit-smoking program administered to a large corporation will be used to demonstrate this method.