ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundBecause of the broad range of activities involved and high variance in clients’ needs, it is challenging to measure the actual dose of case management in order to assess quality and manage outcomes.ObjectiveThe purpose of this research is to evaluate the impact of intervention dosage on client outcomes in different case management models within substance abuse treatment.MethodA descriptive and repeated measures analysis from a clinical trials data set measured the dosage of case management and evaluated impact on client outcomes. A sample of 598 clients from a substance abuse treatment facility was randomized into one of four groups, assessed at intake and then followed for 1 year. Three groups received a form of case management as an intervention (n= 437), and all clients received drug treatment.ResultsClients who engaged (actively participated) in case management were less likely to have legal and family issues but more likely to have a chronic medical condition at baseline. Dosage factors differed significantly across treatment conditions. In general, dose was significantly related to outcomes in the legal and family domains.ConclusionsAlthough complex, case management intervention dosage can be measured using the model presented. Dosage determination aids cost-effective initiatives. Further research is needed to specify intervention protocols.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundIn the United States it is estimated that more than 30 million workers are exposed to harmful levels of noise on the job. When engineering or administrative controls cannot be used to reduce noise, workers should always use hearing protection devices (HPDs) when exposed to loud noise to prevent noise-induced hearing loss (NIHL). Previous research has shown that workers do not always use HPDs when required; therefore, it is essential that workers assume personal responsibility for preventing NIHL by increasing their use of HPDs.ObjectivesThis study tested the effectiveness of an individually tailored multimedia intervention to increase use of HPDs by factory workers.MethodsA randomized controlled design was used to compare the effects of a tailored intervention (n= 446) with two other interventions (a nontailored predictor-based intervention (n= 447) and a control intervention (n= 432)) on workers’ self-reported use of HPDs 6 to 18 months following the intervention.ResultsOnly those workers receiving the tailored intervention significantly increased their use of HPDs from pretest to posttest. However, this increase significantly differed from the nontailored group but not from the control group.ConclusionsIndividually-tailored interventions offer promise for changing behavior. In light of the similarity between the results for the tailored intervention and the control intervention groups, further research is needed to understand barriers to HPD use and how to maximize the benefits of individually tailored interventions in this setting.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundPostpartum depression is a global phenomenon.ObjectiveThe purpose of this study was to develop and psychometrically evaluate the Spanish version of thePostpartum Depression Screening Scale (PDSS).MethodsEight translators representing the predominant Hispanic groups in the United States translated thePDSSinto a Spanish version. A total of 377 Hispanic mothers completed thePDSS-Spanish Versionwithin 12 weeks postpartum at two sites: Connecticut and Texas. Confirmatory factor analysis and item response theory analysis were conducted to assess construct validity.ResultsFor the total sample of 377 Hispanic women, the alpha reliability for the totalPDSSwas .95; dimension-level alphas ranged from .76 to .90. The totalPDSSalphas by group were as follows: .94 (Mexican), .96 (Puerto Rican), and .93 (Other). Confirmatory factor analysis provided empirical support for the existence of the hypothesized constructs assessed by thePDSS.Item response theory analysis supported the adequacy of the construct definitions and confirmed that the response options for the Likert categories were an “ordered” attitude continuum in which higher responses corresponded to higher levels of “agreement” with the depressive symptomatology items.ConclusionsWhen compared to the original EnglishPDSS,the reliability and validity psychometrics for the Spanish version were slightly lower, but still within the acceptable range.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundAlthough nurse clinicians and researchers use infant behaviors to indicate the responses of preterm infant to stimulation, little is known about how the biological factors of development, sleeping and waking states, infant characteristics, and infant illness severity affect preterm infant behaviors.ObjectiveThis study examined the development of eight infant behaviors over the preterm period and determined the relation of these behaviors to sleeping and waking and to infant characteristics and illness severity.MethodsSeventy-one preterm infants were observed once per week from 7:00 p.m. to 11:00 p.m. from the time they were no longer critical until term or discharge. The occurrence of four sleep-wake states and eight behaviors were recorded every 10 seconds during the observations.ResultsNegative facial expressions increased over the preterm period; sighs, startle/jerks, jitters, and the likelihood of having hiccups decreased. Infant characteristics had only minor effects: boys had more negative facial expressions, and longer mechanical ventilation was associated with more sighs and jitters. All behaviors showed state-related differences in frequency. In addition, only startle/jerks and jitters showed the same developmental patterns within each state.ConclusionsSignificant development of infant behaviors occurs over the preterm period but involves changes not only in the absolute percentage of each behavior but also in the percentages within each sleeping and waking state. Thus, preterm infant behaviors cannot be used clinically for assessment without consideration of the state in which they occur.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundSpouses of patients with cancer are at risk for stress-related disorders and may experience a reduction in immune function. Therapeutic back massage (TBM) has been shown to enhance relaxation and thus, may reduce stress associated with caring for an ill partner.ObjectivesTo determine if TBM’s influences on psychosocial, physiologic, and immune function variables in spouses of patients with cancer, and explore the relationships between psychosocial variables and immune function in spouses of patients with cancer.MethodsThis group experimental design measured the effects of a 20-minute TBM at three time points (preintervention, immediately postintervention, 20 minutes postintervention) on spouses of patients with cancer (N= 42) randomly assigned to either the experimental or control group. The major dependent variables including natural killer cell activity (NKCA), heart rate, systolic and diastolic blood pressure, mood, and perceived stress were measured at the three time points to examine the effects of TBM. Data collected on measures of mood and perceived stress were correlated with NKCA to examine their relationships. Prior to hypotheses testing, data collected on measures of depressive mood, loneliness, marital disruption, and health practices were also correlated with NKCA to ascertain any possible confounding variables.ResultsTwo-way repeated measures analysis of variance tests determined the effects of TBM over the two postintervention time points and resulted in significant group x time interactions on mood (F[2, 40]= 14.61,p= .0005) and perceived stress (F[2, 40]= 28.66,p= .001). Significant inverse relationships were found between mood and NKCA (r= -.41,p= .009,N= 42) and perceived stress and NKCA (r= -.37,p= .017,N= 42).DiscussionFindings suggest that TBM may enhance mood and reduce perceived stress in this population. Insight was gained into the psycho-immunologic relationships studied.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundDespite ongoing physical and psychological distress, little is known about sense of coherence (SOC) and holistic quality of life (QOL) in women with irritable bowel syndrome (IBS).ObjectivesThe purposes of this study were to (a) describe and compare SOC and holistic QOL of women with and without IBS, and (b) examine the relationships among SOC, holistic QOL, and gastrointestinal (GI) and psychological distress symptoms.MethodA two-group comparison design was used to test the study hypotheses that women with IBS would have lower SOC and holistic QOL than control women without IBS, and that SOC and holistic QOL would be inversely related to GI and psychological distress. A total of 324 women were studied (n= 235 with IBS,n= 89 controls). Measures included the 13-item SOC Questionnaire, Modified Flanagan QOL Scale, Bowel Disease Questionnaire, and Symptom-Checklist-90-R.ResultsBoth SOC and holistic QOL were lower in women with IBS (p<.001). Correlations between SOC and global distress, depression, anxiety, and somatization without GI symptoms were moderately and inversely related (r= −.64, −.64, −.53, and −.31, respectively;p<.001) in the total sample. Relationships between holistic QOL and psychological distress indicators were universally of lower magnitude (r= −.56 to −.27,p<.001). The only GI symptom indicator significantly related to SOC and holistic QOL was alternating constipation and diarrhea (τ= −.21 and −.17, respectively;p<.001).DiscussionWomen with IBS have a reduced SOC and holistic QOL when compared to women without IBS. It remains to be determined whether interventions targeted at enhancing SOC and holistic QOL can impact the psychological distress associated with IBS.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveAlthough a majority of women (80%) at menopause experience hot flashes, the symptoms’ physiological trigger has yet to be identified. To determine the relationship between glucose availability and hot flashes in menopausal women, hot flash frequency was compared between intervals while the subjects were fasting and/or infusing in a sample of menopausal women (38–55 years of age).DesignAn experimental study was conducted in 10 postmenopausal women taking hormone therapy (HT) between the ages of 38 and 55. Following a clinic visit to screen for general health and absence of diabetes, HT participants were asked to stop the medication for 7 to 10 days and to maintain a diary of hot flash frequency. When hot flashes were experienced at least four times per day in a consecutive 3-day period, participants were admitted to the General Clinical Research Center for a 30-hour experimental protocol, including frequent blood sampling and two experimental periods of intravenous infusion of glucose or normal saline. Blood glucose levels were manipulated to provide conditions of postprandial versus fasting states.ResultsThere was a significant reduction in the incidence of hot flashes during the experimental elevation of glucose concentrations (130 to 140 mg/dl) compared to the fasting state (<110 mg/dl) (t= −2.4,df= 9,p= .04).ConclusionsConditions of fasting may stimulate the trigger mechanism for menopausal hot flashes.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundThe Health Insurance Portability and Accountability Act (HIPAA) privacy regulations, which became effective on April 14, 2003, should have a significant impact on the conduct of nursing research.ApproachThe requirements of the regulations are discussed in three key areas of the research process, accessing data (including recruitment and using medical records), creating data (including intervention studies, survey, and interview research), and disclosing data to others such as colleagues at other institutions.ResultsN/A.DiscussionHIPAA will certainly impact nurses’ ability to conduct research but to an unknown degree.

ISSN:0029-6562    

出版商:OVID    

年代:2003

数据来源: OVID