Showing papers in "Research in Nursing & Health in 1978"

Sensory information, instruction in a coping strategy, and recovery from surgery

Abstract: A study of 81 cholecystectomy patients evaluated the relative contributions of instruction in a specific coping strategy and two types of informational interventions on subjective and objective indicators of recovery from surgery. The two experimental factors in the 2 × 3 × 2 factorial design were instruction in coping activities (present or absent) and information (description of typical sensations, description of typical events, or no information). The nonexperimental factor was preoperative fear (high or low). Self-report of moods, severity of pain, and bother of ambulation were the subjective indicators. Analgesics received, amount of ambulation, length of postoperative hospitalization, and time after hospital discharge before patients ventured from their homes were the objective indicators. Instruction in coping activities, description of sensations, and description of events all were found to dampen negative moods postoperatively for patients relatively fearful before surgery. Description of typical sensations significantly reduced the length of postoperative hospitalization and time after hospital discharge before patients ventured from their homes. Another sutdy of 68 herniorrhaphy patients, using the same design, resulted in only minor effects for any of the three interventions. Explanations for the different results between studies are offered.

Recovery from rape and prior life stress

Abstract: This longitudinal study on rape victims looks at four life stress events and their association with recovery from rape. Data from 88% of the original sample of 92 adult victims 4 to 6 years after rape suggest that life stress before rape may act to hasten or to inhibit the recovery process. Stress is not uniform in its effect. Different types of stress have different effects. Earlier victimization and chronic life stressors such as economic hardship, lack of social support, and pre-existing biopsychosocial problems tend to delay recovery. In contrast, family grief stress may act as an energizing factor in that coping skills may have been developed through experiencing the grief process and are available to the victim for settlement of rape trauma. Recent life changes have a lack of association with recovery although they may be important in some individual cases.

Altering patients' responses to surgery: An extension and replication

Abstract: This study of 58 cholecystectomy and 57 herniorrhaphy patients was designed to determine the reliability of the effects of preoperative preparation on postoperative recovery that were observed in a previous study. The preoperative preparation consisted of information that focused on the typical subjective sensory experiences of surgical patients in combination with instruction in postoperative exercises. The effects of prehospital admission preparation, restatement postoperatively of preparatory information, and adding temporal orienting information to the preparatory information on postoperative course were also examined. The main results of the original study were replicated. In the cholecystectomy sample, the preoperative information intervention significantly reduced length of postoperative hospitalization and length of time posthospital discharge before patients ventured from home. Temporal orienting information reduced feelings of helplessness postoperatively in the cholecystectomy sample. Consistent with the original study, only trends for effects were observed in the herniorrhaphy sample.

The effect of nonnutritive sucking on transcutaneous oxygen tension in noncrying, preterrn neonates

Abstract: The relationship between transcutaneous oxygen tension (tcpO2:) and sucking opportunities in noncrying, preterm neonates was investigated. Twenty-six measurements of nonnutritive sucking and its relationship to tcpO2 were collected on 11 neonates who were monitored continuously for tcpO2. Of the 26, 10 sets of measurements were recorded on 6 neonates receiving assisted ventilation, and 16 were recorded on 4 neonates breathing room air. One neonate was measured one time on assisted ventilation and two times breathing room air. The design consisted of three 8-minute time periods: pretreatment, treatment (sucking opportunities). and posttreatment. There was a significant relationship between the pretreatment-treatment and treatment-posttreatment tcpO2 levels (both at p < .01). These results suggest that sucking facilitates more adequate oxygenation in noncrying, preterm neonates.

The relationship between auditory stimulation and gross motor activity of short-gestation infants.

Abstract: The short-gestation infant is at risk for both mortality and morbidity. His writhing contributes to weight loss; his extrauterine environment does not contain the multimodality patterned afferent stimuli that excite the developing brain in utero. Sound is the most effective modality to achieve concurrent decrement in motility along with enhancement of cortical activity. It was anticipated that by 36 gestational weeks, subjects exposed to 5 min. of patterned sound 6 times a day would (a) evidence less gross motor activity and (b) evidence a greater decrease in motor actitvity with a maternal auditory stimulus than with a musical auditory stimulus. The sample consisted of 80 males and 73 females whose gestational age at birth was 26 to 33 weeks. Fifty-two subjects were randomly assigned to the control group, 50 to a tape of their mother's voice, and 51 to a lullaby. Limb activity was measured just before discharge by accelerometers worn unilaterally for a 24-hr. period on the ankle and wrist prior to transfer to the alternate side for a further 24 hr. No statistically significant differences were demonstrated among the three groups' limb patterns. Large intragroup variation in gross activity precluded demonstration of between-group differences. The majority of subjects evidenced predominance of upper limb activity and laterality.

The notion of a practice theory and the relationship of scientific and ethical knowledge to practice.

Abstract: By examining the relationship of scientific and ethical knowledge to practice, it can be shown that much of the knowledge required for practice is the knowledge of science and ethics. This brings the notion of the need for a practice theory in nursing into serious question since unique knowledge beyond that of science and ethics must be shown to be required in practice.

Fatigue in the patient with multiple sclerosis

Abstract: Three hundred thirty-five multiple sclerosis patients and 30 healthy persons completed a questionnaire retrospectively about their fatigue experiences throughout a usual day. Using a Type I design (Lindquist, 1956) to analyze differences in daily fatigue feelings, five subject groups (four patient groups with different levels of mobility and one healthy control group) were compared. A significant difference in the degree of fatigue feelings felt by the groups was found. The patients with multiple sclerosis, regardless of mobility level, experienced more severe feelings of fatigue throughout the day than did the healthy subjects. Also, the less mobile groups experienced more severe levels of fatigue. No significant difference was noted in the patterns of the five groups' fatigue progression. No significant differences in types of fatigue symptoms were found between the subject groups. The following characteristics were more apparent in the patient groups than in the healthy subjects when fatigued: () disease symptoms appeared to be accentuated and () there were greater indications of emotional stress.

Perceived situational control of daily activities: A new tool

Abstract: This article reports the development of a tool for the measurement of Situational Control of Daily Activities (SCD) in an institutional setting for the elderly. Specific items for the SCDA were derived from the analysis of field notes from an exploratory study Content validity was established by a panel of judges. Test-retest reliability for 20 subjects was .96. Intercoder reliability (among the investigator and two independent coders) was 1.0 for the overall category of “self-” or “other-” determination for each respondent and .98 for categorization by activity for the respondents. Factor analysis of 79 subjects revealed the presence of two factors in the structure, Factor I, Control of Socializing and Privacy, and Factor II, Control of Physical Care. Further work is needed to refine the items and then the tool should be tested with larger samples.

Florence nightingale as statistician

Abstract: (1916). Florence Nightingale as Statistician. Quarterly Publications of the American Statistical Association: Vol. 15, No. 116, pp. 388-404.

The association of knowledge and perception of medications with compliance and health states among hypertension patients: a prospective study.

Abstract: The purposes of this prospective study were () to describe the associations among patients' knowledge of medications and perceptions of side effects and benefits of medications, () to clarify the independent effects of knowledge and perceptions of side effects upon patients' reports of compliance with medications, and (c) to describe the relationship between compliance and patients' health states as measured by a reduction in diastolic blood pressure. Eighty-eight diagnosed hypertensive patients were interviewed at the onset of a medication regimen and at the end of 5 months. Audits of medical records were completed for the entire 5-month period. The results indicated that both knowledge and perceptions of benefits from medications were significantly correlated with patient compliance at the beginning and at the end observations. The partial correlations, however, indicated that knowledge of medications had a greater independent association with compliance at the beginning of the study and that perceptions of benefits from medications had a greater independent association with compliance at the end observation period. Finally, patients who, on the average, complied with their medications more than two-thirds of the time experienced a clinically significant reduction in their diastolic blood pressure. The results of the study suggest that knowledge may serve to stimulate compliance at the beginning of a treatment regimen, whereas perceptions are more effective stimulants once therapy has begun. These findings are discussed in view of the literature on patient knowledge and their implications for primary care providers.

Temporal experience and motor behavior among the aging.

Abstract: This study was designed to provide comparative data among institutionalized and noninstitutionalized persons between 70 and 89 years of age. Several measures of temporal experience and body movement were used to compare the groups. One-half of the sample were nursing home residents, and the other half lived in their own or relatives' homes. Differences between the institutionalized and noninstitutionalized groups were observed. The institutionalized group was more past oriented and displayed more gross motor activity. Older persons projected further into the past than did the younger persons.

The need for a practice theory as indicated by the knowledge used in the conduct of practice

Abstract: By examining the knowledge used in the conduct of practice, the knowledge required for practice can be shown to be completely reducible to science, ethics, and logic. Consequently, all notions of a practice theory in nursing are likely to represent some combination of these kinds of knowledge. As a result, no need for a practice theory exists.

Contributions of the passionate statistician

Abstract: Information available about the mathematical and statistical training of Florence Nightingale is presented The state of development of statistics at the beginning of her research activity is summarized in terms of the techniques available at that time and in terms of the modern statistical tools that had not been invented A few of her specific contributions to statistical methodology are noted A series of questions is given in the hope of stimulating further inquiry into Nightingale's quantitive methods and research contributions

Patient encounters by primary care nurse students.

Abstract: Student-patient encounter data were systematically documented. Health problems identified by primary care nurse students were classified and analyzed. Primary health care practicums in three areas of specialization were obstetric-gynecologic, general adult, and pediatric services. A student-patient encounter form was constructed to record encounter data. A total of 1,689 encounter forms were completed by 30 nurse students enrolled in primary health care practicums during the years 1972–75. The identified health problems were classified by the International Classification of Diseases Adapted for Use in the United States. The results indicated: (a) the focus of primary health care for obstetric-gynecologic and pediatric patients was on health maintenance, whereas the focus for general adult patients was on illness care; (b) symptoms and ill-defined health conditions were frequently encountered by the students, particularly with general adult patients; (c) a cluster of health problems was identified for each of the three areas of specialization. The findings seemed to justify the need to develop a health problem classification system for primary health care.

Sex differences in sick role behavior during hospitalization after open heart surgery.

Abstract: The proposition examined here is that there are sex differences in the enactment of the sick role. Specifically, in comparing the recovery of 50 male and 50 female patients following open heart surgery, it was hypothesized that male patients would (a) be transferred from the cardiac recovery room earlier, (b) be discharged from the hospital earlier, (c) achieve independence in self-care and in ambulation earlier, and (d) receive fewer pain medications and tranquilizers. Support was found only for the hypotheses of earlier hospital discharge and earlier self-care. The patient's physical condition—indicated by type of surgery, time in operating room, time on bypass, and units of blood—was related to time in recovery room and length of postoperative hospitalization. Of the variables examined, age emerged as the most powerful predictor of medication dosage, with older patients receiving significantly fewer analgesics and tranquilizers. The following conclusions were reached: (a) the salience of sex role expectations for sick role behavior varies with the particular measure considered and (b) the overall significance of sex role expectations in determining sick role behavior was slight for this sample of seriously ill patients.

Parents' perceptions, attitudes, and needs regarding sex education for the child with myelomeningocele.

Abstract: Nurses working in a multidisciplinary outpatient clinic for children with myelomeningocele desired to learn more about parents' ideas and needs in the area of sex education. Private interviews were conducted with 52 parents, using a structured interview guide. Mothers were seen as the main sex educator for girls, whereas both parents were seen as sex educators for boys. Sixty percent of the parents believed that sex education should begin during the school-age years. Lack of adequate knowledge about their child's potential for sexual functioning was perceived by all parents. Parents' responses indicated a need for clinic staff to “open the door” to discussing sexuality and a need for realistic guidance about their child's sexual potential. Parents indicated that they saw the referral hospital as a more helpful resource than local resource persons, and selected means by which they and their children might learn more about sexuality from clinic staff. Based on information gathered in the study, clinic staff can plan a teaching and counseling program to help parents become more effective sex educators.

Correlates of success in the baccalaureate education of registered nurses

Abstract: The major purpose of this investigation was to identify correlates of success in a baccalaureate completion program to aid in the selection of registered nurses. The sample included 170 graduates from one baccalaureate program. Their ages ranged from 20 to 51; 79% graduated from a diploma program and 21% from a community college associate degree (AD) program. The predictors of achievement were () age, () diploma versus associate degree background, (c) work experience, (d) six validation examination scores, and (e) two entry grade point averages (GPAs) based on liberal arts and nursing subjects. respectively. The criteria of success were two exit GPAs from the baccalaureate program, based on liberal arts and nursing subjects. Comparison of mean scores and multiple regression analyses were used to relate predictors and criteria. The major conclusions are that () entry liberal arts GPA is the best predictor of achievement in this baccalaureate program, irrespective of how long ago it was obtained; () diploma school graduates perform better than junior college graduates in the classroom as well as in clinical practice; and (c) age is NOT a factor in performance in a baccalaureate completion program.

Effects of thermal applications on the abdominal temperature of dogs.

Abstract: The results of thermal applications to the abdomens of restrained, unanesthetized rats are reported. A silicone envelope through which water at 0. 10, 20, 30, 40, or 50°C circulated was applied while skin surface, subcutaneous, intraperitoneal, and colonic temperatures were measured. Pad applications at 0°C significantly lowered tissue temperature at all four locations measured. Pad applications at 10 and 20°C significantly lowered skin surface, subcutaneous, and intraperitoneal temperatures. Pad applications at 30°C significantly lowered skin surface and subcutaneous temperatures. Pad applications at 40 and 50°C significantly increased skin surface and subcutaneous temperatures, and applications at 50°C also increased intraperitoneal temperature. lntraperitoneal and colonic temperatures were insignificantly affected by pad applications of 30 and 40°C, and colonic temperatures were not significantly altered by any thermal application other than that at 0°C. The findings indicate that application of mild heat or cold (30–40°C) to the abdominal skin of the rat does not alter deep abdominal temperatures, indicating no deep vasomotor response to these thermal applications. The question can be raised whether these results suggest that a similar response may occur in humans.