Page 569 - Encyclopedia of Nursing Research

536 n VULNERABLE PoPULATIoNS

(Glasglow et al., 2006). other reviewers found
effective chronic disease management on the Vulnerable PoPulations
V Internet (Fry & Neff, 2009; Nelson, Barn, &
Cain, 2003).
overall, the Internet allows the patient More than 717,000 unduplicated articles
and caregiver to choose when and what infor- spanning the years 1982 through 2010 were
mation to access when needed. Furthermore, identified via www.scholar.google.com
results from the VNC questionnaire found using the key terms “vulnerable” and “popu-
nurse Web sites provided patients and care- lations.” The most frequently cited authors
givers with interactive anticipatory guid- were Gelberg, Anderson, and Leake (2000;
ance, scientifically based information, and a n = 250) and Aday (2001; n = 302). A surfeit
sense of nurse caring from a distance (Smith, of research has examined vulnerable popu-
Kochinda, yadrich, & Gajewski, 2010). lations (VPs) over this past decade (2000–
Notably, insurers will reimburse three 2010). A search through Elton B. Stephens’
times as many distant contacts versus Company (EBSCohost) for electronic jour-
in-home traditional visits because of the nals using the same parameters generated
lower travel and personnel costs (National 4,922 articles. An advanced search through
Association for Home Care and Hospice, EBCSo set for “research” and “nursing”
2009). Millions of dollars are spent annually resulted in 345 studies. The focus of these
on morbidities-associated chronic illnesses studies were veterans, cultural approaches,
and on preventable home care complications, social justice using human subjects, global
such as IV infections. Reducing IV infections, populations and disasters, and the reduc-
one of the top 25 research priorities (Institute tion of health disparities. A search through
of Medicine, 2009), can be accomplished by the Cumulative Index to Nursing and Allied
Internet instructions and prompts (Smith, Health Literature database using the search
2005, 2007a, 2007b). However, of the 557 selection terms “vulnerable,” “populations,”
peer-reviewed articles on distant nursing and “research” between the years 2000 and
(none on cell phones or the Internet), only 2010 resulted in 266 studies. The focus of these
55 included costs and only 24 of those used articles were gang youth, prisoners, interna-
standardized cost measurement as used in tional populations and settings, the effective-
this study (Whitten et al., 2002). There is a ness of nursing interventions, system-related
need to determine the cost-efficiency and delivery of care structures and values on
clinical effectiveness of mobile phone ver- impact of care (i.e., ER use and primary care
sus Internet nursing interventions guides vs. faith-based nursing settings and school-
(Smith, 2007a, 2007b). based clinics), the development of theory and
Future directions of research are to test science, measurement issues and instrument
new technologies to convey VNC. Specifically, development, and policy. In essence, earlier
research must test if mobile telephones can research focuses on identifying populations
access the Internet, illustrate health care most at-risk and later research focuses on
treatment, answer common illness questions, methods for improvement in research and
and provide decision-making guides and outcomes.
automated symptom or health assessments. VPs in reference to human beings are
Also, research on the impact of VNC on clin- those identified as being at-risk for health
ical outcomes and privacy in relation to using problems, harm, or neglect (Aday, 2001;
the Internet should be undertaken (dilworth- Leight, 2003). Most often, these humans
Anderson et al., 2005; Im & Chee, 2002). are referred to as “the poor and those with
chronic illnesses” or people who are less for-
Carol E. Smith tunate than others due to low socioeconomic