This chapter focuses on the National Institutes of Health (NIH) T32 National Research Service Award (NRSA) funding mechanism, designed to enhance the development of nurse scientists. The general history and principles underlying NIH funding for T32s as well as the National Institute of Nursing Research's (NINR) involvement in the NRSA program is described, highlighting the University of California Los Angeles School of Nursing's T32 training program in vulnerable populations research and the program and career trajectory data from close to two-thirds of NINR-funded T32s directors. Recommendations for the improvement of NINR-funded T32 training programs are identified. Findings include the need for increased collaboration between institutions receiving T32 funding from the NINR.
[Show abstract][Hide abstract] ABSTRACT: About 20% of Americans live in rural America, yet the rural mental health infrastructure has yet to be firmly established. This is due in part to a pervasive belief about the tranquility of rural places and the relatively stress-free environment that they produce. In this chapter an adaptation of the Rural De Facto Mental Health Systems Model produced by Fox and her associates at the Southeastern Rural Mental Health Research Center is presented and used to organize the scientific state of the field of rural mental health services research. As many nurses have stood at the forefront of that research, the research of several prominent rural mental health nurse researchers and the innovative research they have produced are reviewed. The chapter concludes with a discussion of research that is needed to move the science of rural mental health services research forward, as well as a discussion of policy initiatives that may be necessary to foster the development and implementation of that research agenda.
Annual review of nursing research 02/2008; 26:143-73.
[Show abstract][Hide abstract] ABSTRACT: Cardiovascular disease (CVD) is the leading cause of death in the United States and around the world. Most of the work done on CVD among rural populations uses mortality versus prevalence rates because prevalence data for rural populations is difficult, if not impossible, to find in national data sets as currently published. Cardiovascular disease is a significant threat to rural dwellers and those in rural nursing need evidence on which to base their practice. This chapter provides an examination of the CVD literature as it relates to rural populations with an emphasis on studies that include or are limited to rural women as subjects. Topics reviewed included: awareness and symptoms of heart disease among women, heart failure (HF) in rural women, hypertension (HTN) in rural areas, stroke in rural populations, quality care in acute myocardial infarction (MI) in rural facilities, mortality and CVD, and CVD risk factors in rural populations. The authors reviewed 134 research articles published between 2000 and 2007. Overall, the CVD research literature in rural populations has small sample sizes, except for epidemiologic studies, and tends to be descriptive in nature. There is a dearth of literature on prevalence among rural populations from a national perspective and little is written on interventions to reduce CVD risks and physiological markers that include large samples from rural populations. Future nursing research on CVD in rural populations needs to move beyond the descriptive to intervention studies, which need to be robust in power to guard against Type II errors.
Annual review of nursing research 02/2008; 26:41-84.
[Show abstract][Hide abstract] ABSTRACT: The purpose of this chapter is to review the literature on quality of care in rural areas. Keywords related to rural quality of care were used to search CINAHL and MEDLINE databases for articles published between 2005 and 2007 (limited to studies occurring in the United States). The review consisted of a total of 46 articles. Limitations include inconsistent definitions of rural, the use of only articles available to the reviewers, an unclear understanding of the context of many of the studies, and lack of a clear operational definition of quality. The studies were grouped and discussed according to quality of workforce, practice, treatment, interventions, and technology in rural areas. Each study's contribution to the understanding of quality health care in rural areas and to determining what was effective in improving staff, patient, or organizational outcomes in rural areas was considered. This chapter also offers a discussion of ethical issues and data quality in rural research. Issues for future research include a focus on patient safety, mental health issues, and the use of technology to improve quality of care in rural areas. Future research should also focus on demonstration studies of model applications. The nursing profession has a unique opportunity to conduct research that will contribute to the development of knowledge that will ultimately improve the quality of health and health care for individuals in rural communities.
Annual review of nursing research 02/2008; 26:175-94.
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