Effects of two intervention strategies on the behavior of nurses and nurse students related to advance directives

Advance directives are one mechanism for preserving the rights of individuals to exercise some control over their health care when serious illness may prevent them from direct participation. Nurses, as the health care providers with the closest and most sustained contact with critically ill and dying patients, are positioned to assist patients to plan for future health care needs. Although a majority of nurses favor the concept of advance directives for their patients and for themselves, they have not played a significant role in facilitating advance health care planning with their patients nor implemented advance health care planning for themselves.^ Research has also shown that differing forms of education and counseling increase the completion rates for advance directives in selected populations, mostly the elderly and seriously ill. Not yet developed are effective educational strategies to assist nurses and nurse students to make optimal contributions in assisting their clients' plans for future health care decision-making. This study sought to determine whether specific learning strategies (a) increased the involvement of nurses and nurse students in facilitating advance care planning with patients and (b) increased the percentage of the nurses' and nurse students' own personal advance care planning activities.^ The study compared two learning interventions and two populations, nurses and nurse students. The participants were randomly assigned to one of the two learning interventions, L1 or L2. Participants in L1 received a lecture, discussion and exploration of the forces impacting on advance directive behavior. Participants in L2 received the same intervention components with the additional component of group practice completing advance directives.^ Analysis of the data by chi-square and logistic regression did not support the hypotheses that the practice component would make a difference in the participants' facilitation of advance care planning with patients or in their own personal advance care planning activities. There were significant differences in post-intervention behavior between the nurse and nurse student groups. The nurses in the study did significantly more facilitation of advance care planning with patients and completed significantly more advance care documents than the nurse students post-intervention. However, the nurse students held more post-intervention family discussions than did the nurses. ^

Entering an academic discourse community: A case study of the coping strategies of eleven English as a Second Language students

This case study follows eleven non-English speaking students as they adapt to community college, content courses. The three classes examined are required freshman classes--Humanities, Social Environment, and Individual in Transition. In order to cope with the demands of these classes, students must penetrate the academic discourse community and have effective relationships with their instructors and their peers. The results of the study are based on interviews with eleven non-native speaking (NNS) students and their instructors and on an analysis of student writing assignments, course syllabi, and exams. Three general areas are examined: (a) students' first-language (L$\sb1$) education, (b) the requirements of their content classes, and (c) the affective factors which influence their adaptation process.^ The case of these students reveals that: (1) Students draw on their L$\sb1$ education, especially in terms of content, as they cope with the demands of these content classes. (2) In some areas L$\sb1$ educational experiences interfere with students' ability to adapt. (3) The content classes require students to have well developed reading, writing, oral, and aural skills. (4) Students must use higher level cognitive skills to be successful in content classes. (5) Affective factors play a role in students' success in content classes. The discussion section includes possible implications of this data for college level English as a Second Language courses. ^

A qualitative study of the impact of an educational intervention on older parents of adults with disabilities engaged in the phenomenon of future-care planning

This phenomenological study describes the impact of an educational intervention on the day-to-day experiences of older parent caregivers of adults with developmental disabilities who were engaged in the process of future-care planning. Qualitative strategies of individual and focus group interviewing were used with a purposive sample of older caregivers. Participants were members of an existing parent support group. Twenty-three caregivers representing 18 families were queried before and after the education program. The disabilities represented were mental retardation, cerebral palsy and autism. Parents whose children live at or away from home were included. The intervention was conducted on five Saturdays over a two month period; the duration of the study was five months. Findings used typical words of the respondents from their individual and focus group interviews to describe feelings, attitudes and experiences in making future-care plans. Data from verbatim transcriptions and researcher's field notes were coded, analyzed, sorted into themes, and subjected to interpretive analysis. Respondents showed a positive change in attitudes and actions after participating in the education program, regardless of their initial stage in care planning. Fears were replaced by hope and determination; hesitation and ineptitude by feelings of competence and confidence; and procrastination and delay by purposeful actions. Other key findings: use of a planning document greatly aided caregivers; barriers to planning were often intrinsic and amenable to education; residential plans were the most difficult aspect of planning; listening to the experiences of other parent caregivers was helpful; and making burial plans for their offspring was one aspect of planning parents wished to do themselves. ^

The effects of a family-based educational intervention on the prevention of lead poisoning in children

The effects of lead exposure may endure through one's lifetime and can negatively effect educational performance. While the link between the cause and effects of lead poisoning has been identified, the application of lead health education as the mechanism of disease prevention has not. The purpose of this study was to examine whether caregiver participation in a family-based educational intervention can result in decreased lead exposure in low socioeconomic children. ^ Participants (n = 50) were caregivers of children 12 to 36 months of age. They were randomly selected from an urban clinic and randomly assigned to either a treatment or control group. The experimental design of this study involved two clinic visits. Parents in the treatment group were given the educational intervention during the first clinic visit while those in the control group were given the intervention during the second clinic visit. The intervention was reinforced with a lead education brochure coupled with a video on childhood lead poisoning. One instrument was used to test parental knowledge of lead poisoning both pre- and post-intervention. Blood lead levels in pediatric participants were tested using two blood lead screens approximately three to four months apart determined by well-child check-up schedules. ^ Findings from the analysis of variance showed the interaction between the change in blood lead level between the children's first and second clinic visits and the treatment level. This demonstrated a significant interaction between the differences of first and second clinic visits blood lead levels and the presence or absence of the educational intervention. ^ The findings from an analysis of covariance support that caregivers in the treatment group have significantly higher scores on the second clinic visit scores on the CLKT than the caregivers in the control group. These data suggest that the educational treatment is effective in increasing the knowledge of caregivers about the dangers of lead poisoning and the strategies for lead poisoning prevention. ^ Conclusions indicate that the education of adult caregivers can affect blood lead levels of children, the educational treatment increased the knowledge of caregivers, caregivers were able to carry out procedures taught, and caregivers retained knowledge over time. ^

Against all odds: Success stories of Latino students who survived the educational pipeline

The purpose of this interview study was to explore the experiences of Latino students, from their perspectives, as they journeyed through the educational pipeline, particularly the part focusing on the transfer experience from a 2-year college to a 4-year institution. This was accomplished by conducting in-depth interviews with 17 self-identified Latino men and women. All of the participants had attended Florida International University for at least 1 semester and had transferred from Miami Dade College. The participants varied in age, generational status, and cultural identity.^ The participants were asked to reflect on the external and internal influences that lead them to the 4-year institution. Tinto's (1993) model of student departure theory provided the theoretical framework for data collection and analysis. Based on the coding of the interviews, numerous themes emerged, including the role of the family, the impact of early education, the experiences of being Latino in Miami, the decisions to choose a college, the experience at the 2-year institution, the experience with the transfer process, and the obstacles and strategies the participants used for overcoming obstacles. These themes were furthered developed to determine which influences were most important for a successful journey through the educational pipeline. ^ The study found that viewing the pipeline via the students' perspectives juxtaposed with Tinto's (1993) model of student departure gave greater insight into the experiences of a population of students who have been underrepresented in higher education. The findings of this case study indicate that the transfer process for Latinos attending a Hispanic Serving Institution such as Florida International University, situated in a majority-minority city, is complex, with participants having to rely on peers and significant others for pertinent information and support. Several factors, including the importance of positive support networks and increased confidence nurtured by the 2-year institution, influenced the students' transfer to a 4-year institution. For professionals in the field, the findings of this study may lead to a broader understanding of the experiences of Latino students in the pipeline and, more importantly, assist college administrators and faculty in successfully guiding a population through a 4-year institution who first came via a 2-year institution. ^

Parents Acquiring Learning Strategies (PALS): How Empowering Hispanic Parents Increases Parental Involvement and Student Achievement

Some Hispanic parents in Miami-Dade County show limited involvement in the educational process of their children. Currently, Miami-Dade County Public schools consists of an increasingly high number of language minority students who come from homes where parents are limited in their English proficiency. Consequently, these parents have difficulty assisting their children with schoolwork and often feel they lack adequate skills to involve themselves in school curricula. The lack of parental involvement by this population has a negative impact on students’ learning and their academic achievement. The purpose of this study is to impact the level of participation of these families and to study its ultimate effect on students’ academic achievement.

Metacognitive Strategies and Learning

During the past decade, metacognition has been identified not only as a component of cognition but also as an important factor in learning. This practitioner proposes that educators and educational researchers should focus on the development and implementation of metacognitive learning strategies. The existing metacognitive studies have concentrated on several areas. One area centers on the continuing efforts to identify all the elements of metacognition. Another area concentrates on the roles that metacognition plays in specific learning behaviors that occur at various ages and levels of complexity. The third area investigates the relationships of metacognition to specific content areas of learning by focusing on the effects of metacognitive learning strategies. The most common areas of study have been reading comprehension, math skills, writing skills, and applying metacognitive strategies to learn various subjects using the computer. Directly or indirectly, the existing studies relate to the expanding applications of the relationships and relevancies of metacognition to learning. Considerable evidence confirms that when students use metacognitive strategies they often experience a higher level of learning. This practitioner believes that experiencing higher levels of learning gives students the confidence they need to construct knowledge which promotes lifelong learning.

Motivational Strategies for Correctional Practitioners

The purpose of this paper is to examine the significance of motivational strategies on offender participation in learning. Education is an effective tool to assist offenders to become productive citizens in society. Therefore, the correctional practitioners must have effective motivational methods to impact the educational development of offenders.

Entering an academic discourse community: A case study of the coping strategies of eleven english as a second language students

This case study follows eleven non-English speaking students as they adapt to community college, content courses. The three classes examined are required freshman classes--Humanities, Social Environment, and Individual in Transition. In order to cope with the demands of these classes, students must penetrate the academic discourse community and have effective relationships with their instructors and their peers. The results of the study are based on interviews with eleven non-native speaking (NNS) students and their instructors and on an analysis of student writing assignments, course syllabi, and exams. Three general areas are examined: (a) students' first-language (L1) education, (b) the requirements of their content classes, and (c) the affective factors which influence their adaptation process. The case of these students reveals that: 1. Students draw on their L1 education, especially in terms of content, as they cope with the demands of these content classes. 2. In some areas L1 educational experiences interfere with students' ability to adapt. 3. The content classes require students to have well developed reading, writing, oral, and aural skills. 4. Students must use higher level cognitive skills to be successful in content classes. 5. Affective factors play a role in students' success in content classes. The discussion section includes possible implications of this data for college level English as a Second Language courses.