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  Patients' expectations of independence-dependence in self-care for the first week after discharge : Orem's self care theory applied to adult medical-surgical patients in one hospital in the Philippines

  (Adventist International Institute of Advanced Studies, 1995-08) Tjakrapawira, Dalmirah

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  Hospitals have an important role in health education for clients. Through discharged planning, a client's need for informed self-care can be met. The purpose of study was to define self-care deficits at discharge as perceived by adult medical-surgical hospitalized patients. The problem addressed in this study was, What activities in discharge planning will best meet the needs of hospitalized adult patients for care at home? Data were gathered at a private church-related hospital in North Philippines. The information obtained was intended to be of value in developing criteria to select patients who need discharge planning. Orem's self-care theory was used to guide this study. This survey study described and compared various subject variables with the patient's assessment of needs for help within the first week of discharge. The tool developed for this study contained 52 items, adapted from a prior tool and organized into 10 subscales based on Orem's self-care theory. Subjects rated each item on a 5-point scale ranging from independence in doing by self (1) to dependence on a health care professional (5). A nonprobability sample of 50 subjects participated in this study. The four major research hypothesis postulated a difference in self-care requirements depending on personal and illness variables, differences in subscales, and in areas of self-care: universal, developmental, and health deviation. ANOVA and t test were used to test for significance. Major conclusions from this study are that older, male, married, and long-term chronic patients have higher dependency needs than do younger, female, or single patients. Patients with less than a high school educational level are more dependent in health deviation self-care area needs than persons with more education. Patients in hospital longer have increased need for discharge planning. Recommendations included repeating the study with a larger sample and in different cultures and settings. Recommendations for nursing administrators included encouraging nurses to emphasize patient teaching or education to enhance quality of nursing care. The card sort used for defining expected self-care needs after discharge could be used as an assessment for discharge protocol.

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  Jerusalem council and doctrinal conflict : an exegetical study of Acts 15:1-35

  (Adventist International Institute of Advanced Studies, 1995-03) Tjakrapawira, D. (Djemingun)

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  Statement of the problem Authority is a significant factor for the existence and the function of the church. A pressing question is raised in regard to the conflict recorded in Acts 15:1-35: What authority did the Jerusalem Council have in regard to resolving doctrinal conflict? Purpose of the Study The purpose of this study is to explore the authority of a council in solving doctrinal conflicts as modeled by Acts 15:1-35. By examining the source, nature and practice of the authority of the Jerusalem Council, one can better understand and apply the concepts governing the authority of the church authority is to be used the contemporary scene. Significance of the Study By examining this issue in depth, certain important Biblical principles can be uncovered which will assist the church in dealing with doctrinal conflicts. Thus, the church will be much better able to fulfill the agent of gospel ministry. Methodology The methodology employed in this study is exegetical and theological. The method adopted is the historical-biblical method implemented by applying the principles of sola scriptura, with the unity of the Bible text as the basic assumption. Findings The study of the confrontation in Acts reveals that an authoritative decision could only be reached through an authoritative body. The church leadership in the hands of the "pillars" did not have enough authority to solve the doctrinal conflict as recorded in Acts 15:1-35. An authoritative assembly was needed to meet that purpose. The Jerusalem council was the highest church authority on earth. The assembly exercised the principles of democracy under a combined influence of Hellenism and Judaism. At the same time, the readers practiced servant leadership. Through a manifestation of representative democracy, the assembly made a decision by consensus endorsed by the Holy Spirit.

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