Ann R. Robach

Bio: Ann R. Robach is an academic researcher. The author has contributed to research in topics: Nurse education & Health care. The author has an hindex of 1, co-authored 1 publications receiving 4 citations.

Perceptions of Patients, Nurses, and Physicians Regarding Nursing as a Profession

Abstract: PERCEPTIONS OF PATIENTS, NURSES, AND PHYSICIANS REGARDING NURSING AS A PROFESSION By Ann R. Robach The United States is facing a critical shortage of nurses. A prevailing societal perception of nursing having a subservient role in health care prevents many recruits from choosing this career, despite efforts by nursing leaders to change this perception (Styles, 1988). The purpose of this study was to determine the current perceptions of patients, nurses, and physicians regarding nursing as a profession. A 20 item modified version of Valiga's View of Nursing Questionnaire was implemented for this study. The subjects included 102 patients, 126 nurses, and 68 physicians who completed the questionnaire in the fall of 1991. Statistical analysis revealed distinct differences among the three groups. The professional attributes of nursing had positive mean scores among all three groups, as well as several traditional attributes. It was concluded that, though some progress toward professionalism had been made, much effort by nurses themselves was still needed to change the traditional perception of nursing.

Circadian sleep–wake rhythm disturbances in end-stage renal disease

Abstract: End-stage renal disease (ESRD) is an increasing health problem worldwide. Given the increasing prevalence of this disease, the high cost of hemodialysis treatment and the burden of hemodialysis on a patient's life, more research on improving the clinical outcomes and the quality of life of hemodialysis-treated patients is warranted. Sleep disturbances are much more prevalent in the dialysis population than in the general population. Several studies investigating the effect and importance of sleep problems on quality of life in dialysis patients revealed that sleep disturbances have a major influence on the vitality and general health of these patients. Sleep disturbances in this patient group are caused both by the pathology of the renal disease and by the dialysis treatment itself. This Review focuses on circadian sleep-wake rhythm disturbances in individuals with ESRD. The possible external and internal influences on sleep-wake rhythmicity in patients with ESRD, such as the effect of dialysis, medications, melatonin and biochemical parameters, are presented. In addition, possible approaches for strengthening the synchronization of the circadian sleep-wake rhythm, such as nocturnal hemodialysis, exogenous melatonin, dialyzate temperature, exogenous erythropoietin, use of bright light and exercise during dialysis treatment, are explored. Further research in this area is warranted, and a greater awareness of sleep problems is needed to improve the quality of life of patients with ESRD.

Patient-Specific Dose Adjustment in the Cancer Clinical Trial Setting

Abstract: Clinical trials of new anticancer therapies are critically important tools in the search for more effective cancer treatments. According to the current paradigm for the clinical evaluation of new cancer therapies, (A) the dose of a therapeutic agent is not adjusted to accommodate individual patient differences, and (B) the exploration of a working-dose of new cancer therapies is mainly restricted to phase I trials. Rogatko et al. proposed that (A′) the dose should be finetuned using patient-specific attributes, and (B′) the search for the optimal dose should be extended beyond phase I and into phases II and III. In this paper, we discuss how phase I design methods can be used to update the working dose for phases II and III and how finetuning the dose may involve the utilization of patient-specific attributes to obtain a personalized treatment regimen. As a result, we expect that more patients will be treated with potentially therapeutic doses of promising agents and fewer patients will have to experience the detrimental effects of a toxic dose.

Determinants of Hospital Administrators' Choice of Anesthesia Practice Model

Abstract: DETERMINANTS OF HOSPITAL ADMINISTRATORS’ CHOICE OF ANESTHESIA PRACTICE MODEL By Maribeth Leigh Massie, Ph.D., CRNA A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2017 Director: Suzanne Wright, PhD, CRNA Vice Chair of Academic Affairs and Director of Doctoral Education Department of Nurse Anesthesia Hospital administrators are being held accountable by patients, insurers, and other stakeholders in evaluating their overall hospital performance to reduce costs and improve efficiency. With the move to alternative payment models and value-based purchasing, hospital administrators must understand the economic viability and value that their specialty services bring to their facility. The purpose of this study was to identify the determinants New England acute care hospital administrators’ utilize in making the choice of anesthesia practice model for their facility. A quantitative, exploratory study of factors hospital administrators use when choosing an anesthesia practice model utilizing a non-experimental, correlational research design was completed. The research was descriptive in nature to determine the factors that influenced a hospital administrator when making decisions about the type of anesthesia practice model that would be the best for their hospital. This research examined seventeen independent variables that were hypothesized to determine hospital administrators’ choice of anesthesia practice model. After the final logistic regression analysis, it was determined that the presence of a hospital being located in a medically underserved area (MUA) alone was a predictor of type of anesthesia practice model utilized. In light of the study limitations and prior literature on the CRNA-only model being present in almost 100% of rural facilities, more exploration is necessary to come to more robust conclusions on predictors of choice of anesthesia practice model determined by hospital administrators. This study showed that there are definitive areas that hospital administrators identify as high importance to the healthy functioning of their facility. By addressing these needs, an anesthesia department could contribute to the overall stability of the hospital, while at the same time, making themselves a more valuable asset overall. Value-driven services offered by anesthesia departments may be the determining factor in choice of anesthesia practice model. By measuring and analyzing anesthesia provider and hospital demographics and hospital administrators’ perceptions of anesthesia services, the objective data collected may assist in defining the most appropriate practice model for a hospital.