Page 274 - Encyclopedia of Nursing Research

HOSpIce n 241

support (Meadows-Oliver, 2005) are also care, (3) the increasing use of technology,
emerging. These insights will facilitate bet- and (4) the Housing First movement. These
ter understanding of the homeless and more factors are directed at changing the health of H
relevant research interventions. the homeless by preventing the occurrence
Few new validated instruments for of homelessness and by making rapid stable
homeless health research have been devel- rehousing the primary care focus. This will
oped. However, one new instrument, the change the direction of research on homeless
ccH consumer Outcome Scales, is promis- health funding.
ing. It measures six major areas of homeless Future funding opportunities will focus
functioning (housing, employment, ben- on new preventive and alternate care modali-
efits, medical, medical health, and substance ties such as medical respite (public and private;
abuse) and includes three outcome scales Zerger, 2005), innovative care management
related to homeless health (cook, Farrell, & models (cooperative, case management, and
perlman, 2007). This instrument may facil- care via assistive technologies—cell phones,
itate larger studies comparing the health of Health Buddy; Zimmerman & Barnason,
homeless groups nationally. 2007), and remote visualization (ludden,
chiu and DiMarco (2010) report a novel 2010). Documentation of quality care, cost
use of instruments to assess the growth analyses, and tracking efficiencies (larimer
and development of preschool homeless et al., 2009) will dominate future research
sheltered children. Their study compared funding decisions.
the results of a nurse administered Denver
Developmental Screening Test II and the Mary J. McNamee
mother’s assessment of her child using the Marilyn Wegehaupt
Ages and Stages Questionnaires instrument.
They report a high degree of comparability
(95%) for nurses and mothers in both gross
motor assessment and personal social devel- HospiCe
opment and 67% comparability in language
development assessment. Although a small
study, this may be a new way for both easier Hospice research in the United States began
and earlier identification of developmental with studies of the differences between hos-
delays in homeless children and foster more pice care and care received in traditional set-
parent educational support. This study needs tings for the terminally ill. Although these
to be replicated with a larger population. studies examined the impact of care provided
In summary, nursing homeless health by hospice, largely nursing care, such studies
research is more diversified than ever with were not nursing research. In canada, Mary
recent publications from five of the six con- Vachon, a U.S.-trained nurse, was invited by
tinents. Most of the studies are small and the palliative care team at the royal Victoria
descriptive, use convenience samples, and are Hospital in Montreal, canada, to investi-
not theory based. research using ethnograph- gate stress in the caregivers who composed
ical-phenomenological study frameworks the palliative care team. Other researchers
(Hubbert, 2005; Martins, 2008; Meadows- examined pain pathways, medications for
Oliver, 2006b; Hunt, 2007) and meta-synthesis pain, and the impact of music therapy. In
(Meadows-Oliver, 2006b) have increased. england, Dame cicely Saunders, trained as
The future direction of homeless health a physician, social worker, and nurse, and
research will be shaped by (1) the patient others examined the impact of medications
protection and Affordable Health care Act for symptom relief. These early studies had
(Hr3590) of 2010, (2) the economics of health as their focus the improvement of care of the