ISSN:0029-6562    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The purpose of this study was to compare the effects of a low-technology environment of care and a nurse case management case delivery system (special care unit, SCU) with the traditional high-technology environment (ICU) and primary nursing care delivery system on the patient outcomes of length of stay, mortality, readmission, complications, satisfaction, and cost. A sample of 220 chronically critically ill patients were randomly assigned to either the SCU (n = 145) or the ICU (n = 75). Few significant differences were found between the two groups in length of stay, mortality, or complications. However, the findings showed significant cost savings in the SCU group in the charges accrued during the study period and in the charges and costs to produce a survivor. The average total cost of delivering care was $5,000 less per patient in the SCU than in the traditional ICU. In addition, the cost to produce a survivor was $19,000 less in the SCU. Results from this 4-year clinical trial demonstrate that nurse case managers in a SCU setting can produce patient outcomes equal to or better than those in the traditional ICU care environment for long-term critically ill patients.

ISSN:0029-6562    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This meta-analysis was an evaluation of patient outcomes of nurse practitioners (NPs) and nurse midwives (NMs), compared with those of physicians, in primary care. The sample included 38 NP and 15 NM studies. Thirty-three outcomes were analyzed. In studies that employed randomization to provider, greater patient compliance with treatment recommendations was shown with NPs than with physicians. In studies that controlled for patient risk in ways other than randomization, patient satisfaction and resolution of pathological conditions were greater for NP patients. NPs were equivalent to MDs on most other variables in controlled studies. In studies that controlled for patient risk, NMs used less technology and analgesia than did physicians in intrapartum care of obstetric patients. NMs achieved neonatal outcomes equivalent to those of physicians. Limitations in data from primary studies precluded answering questions of why and under what conditions these outcomes apply and whether these services are cost-effective.

ISSN:0029-6562    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This survey examined the relationships of sexual risk taking to substance use and AIDS knowledge in pregnant adolescents (n = 58) and nonpregnant young mothers (n = 93). Subjects were from predominantly minority backgrounds, were single, and ranged in age from 12 to 20 years (M = 16.64). A number of high-risk behaviors were reported, including substance use during pregnancy and early parenthood, unprotected sexual relations, and multiple (lifetime) sex partners. Current pregnancy status, history of marijuana use, and ethnicity were strong predictors of having bad multiple sex partners. Odds ratios suggested that Black adolescents were many times more likely than Whites to have had multiple sex partners. Pregnant adolescents were less likely than young mothers (nonpregnant) to have had multiple sex partners but more likely to have unprotected sex (i.e., without use of a condom). Conversely, young mothers were more likely to have multiple sex partners and less likely to have unprotected sex than were pregnant adolescents. Those with a history of marijuana use were more likely to have had multiple sex partners than were adolescents who had never used this drug. AIDS knowledge was not a significant predictor of high-risk sexual behavior.

ISSN:0029-6562    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study was designed to evaluate whether maintenance of a moist environment on the nipple skin during the first week of breast-feeding would improve damaged nipple skin condition, as indicated by the presence of eschar, erythema, and fissures, and reduce pain. Fifty White women applied a polyethylene film dressing with a perimeter adhesive system to a randomly determined nipple. The dressing was present at all times except during feeding. Subjects were assessed every 48 hours (four times) over 7 days. Serial photographic slides were obtained and assessed for skin characteristics. Nipple pain was self-rated with a verbal descriptor scale. Use of an occlusive film dressing on nipple skin during the first week of breast-feeding appeared to have limited influence on improvement in damaged skin condition. Summary scores indicated significant reduction in the amount of eschar on the surface of the nipple. There were no differences in erythema intensity or fissure severity. Use of a dressing significantly reduced nipple pain during the study period.

ISSN:0029-6562    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article is a report of data derived from two investigations. In one study, the relationship between early initiation and frequency of breast stimulation to feeding pattern at 8 weeks postpartum in mothers of low-birth-weight (LBW; ≤ 2500 g) infants was examined. The other study examined how selected physical, psychological, and management variables affect milk volume in mothers of very-low-birth-weight (VLBW; ≤ 1500 g) infants. Initiation and frequency of breast stimulation were studied in both investigations. Mothers of LBW (N = 110) and VLBW (N = 16) infants had delayed initiation of breast stimulation after delivery and low pumping frequency. No relationship was found between early initiation and frequency of breast stimulation to feeding pattern in mothers of LBW infants.

ISSN:0029-6562    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Distress and autonomy behaviors were examined in 80 preschool children of pregnant mothers and nonexpectant mothers. Four groups of only children participated: three groups of 20 children of expectant mothers who were in their early, middle, or late stages of pregnancy and a comparison group of 20 children of nonexpectant mothers. The groups were balanced for age (young: 18 to 36 months; old: 37 to 60 months) and sex. At 12 weeks, young firstborn girls were more dependent than either young boys or older girls and boys. Firstborns in the middle pregnancy group were more dependent at 20 weeks than at 24 and 28 weeks; however, boys reacted more to separation and expressed more anger than did girls. During the late phase of pregnancy, boys reacted to separation more negatively than girls did only at 28 weeks. Old firstborns were generally more autonomous than young firstborns; however, by the 32nd week of pregnancy, the groups did not differ. Compared with children in the comparison group, those in the early pregnancy group showed fewer reactions to separation, and those in the middle pregnancy group were less dependent at 24 and 28 weeks. At 38 weeks of pregnancy, late pregnancy boys reacted less to separation and expressed less anger than did comparison group boys. Late pregnancy girls were angrier than boys in both the comparison and pregnancy groups.

ISSN:0029-6562    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

A grounded theory method was used to study nurses' clinical decision making. Field notes, in-depth interviews, and documents were analyzed. The beginning process model contained the core concept, knowing the patient, a purposeful action whereby the nurse uses understanding of the patient's experiences, behaviors, feelings, and/or perceptions to select individualized interventions. Familiarity and intimacy were the properties of the core process; the patient-nurse interaction was the context. Three conditions included time, the nurse's experience, and other nurses' input. Four strategies facilitated the core process: empathizing, matching a pattern, developing a bigger picture, and balancing preferences with difficulties. Different strategies were used, as time and familiarity with the patient varied.

ISSN:0029-6562    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

As part of a study of patient-centered care outcomes that requires the ability to be interviewed by telephone after hospital-ization, 4,600 adult patients on 118 medical-surgical units in 17 midwestern hospitals selected by stratified random sampling were identified as potential subjects. This article describes response-rate differences and reasons for nonpartici-pation by gender, age, ethnicity, and race. Issues related to understanding and reporting response rates, reducing losses due to ineligibility, dealing with refusals, and tailoring survey approaches to special populations are discussed.

ISSN:0029-6562    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0029-6562    

出版商:OVID    

年代:1995

数据来源: OVID