Term of Award

Winter 1996

Degree Name

Master of Nursing

Document Type and Release Option

Thesis (restricted to Georgia Southern)

Committee Chair

Marcella A. Hart

Committee Member 1

Camille P. Stern

Committee Member 2

Rosalyn L. Roesel


For more than ten years now, there has been a shift in population from the acute care setting to the ambulatory care setting. Much of the health care that previously occurred in hospitals is now taking place in community-based ambulatory centers variously known as emergicenters, urgicenters, medical care walk-in centers, and doc-in-a-boxes Other major providers of ambulatory care are Community Health Centers which include Migrant Health Centers, Health Care for the Homeless Projects, and Primary Care Associations which are the focal points of this study.

With the change in health care delivery comes a demographic trend which is evident in current statistics Today, one person out of nine in the United States is over the age of 65 Nurse administrators of community health centers are challenged to properly equip their nursing staff with educational opportunities which reflect the uniqueness of an aging population This study was a partial replication of one conducted by Bevan (1992) wherein hospitals were surveyed regarding their provisions of programs/offerings for their nursing staff related to the care of the older adult However, the present study surveyed community health centers and was designed to answer research questions surrounding the scope, frequency, and occurrence of nursing orientation, continuing education, and inservice programs/offerings related to care of the older adult in the community health setting.

The theoretical framework utilized was Dorothea Orem's Self-Care Deficit Theory of Nursing (S-CDTN), with emphasis on the concept of nursing agency It is the responsibility of the nurse administrator to ensure that nurses who are providing care have the capabilities to properly function Nurses, through education, develop nursing agency or capabilities which foster positive responses to care of the older adult Nurses with adequate nursing agency can transfer information related to self-care at a level of understanding whereby older adults can be comfortable in caring for themselves in the transition of self-care related activities from the community health setting to the home setting The community health care environment brings a new demand for this type of nursing.

Questionnaires were mailed to each community center (N= 150) located in the nine South Atlantic States Sixty-three centers responded, giving a 42% response rate Utilizing a nonexperimental descriptive design, frequencies, percentages, and the chi-square test were used to analyze data obtained.

The findings of the study indicated that while community health centers provided programs/offerings related to the care of the older adult, these programs/offerings might not be current Factors such as location, size, or resources of the community health center did not seem to significantly impact the provision of programs/offerings related to care of the older adult. The provision of and staff attendance to such programs/offerings was voluntary The study underscores the need for the nurse administrator to take the leadership role in advocating programs/offerings and services specifically designed to focus on the care of the older adult.

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