ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

In this era of rapid, scientific medical advances, we still live with the myth that urinary incontinence should be accepted as a normal part of aging. Urinary incontinence, however, should not be considered a disease but rather a symptom or sign of an underlying problem. Patients with urinary incontinence now have many places to turn for advice and medical treatment. In addition to urologists, gynecologists, and geriatricians, nurses are actively involved in the evaluation and management of patients with urinary incontinence. The purpose of this article is to outline a systematic nursing approach to the evaluation, diagnosis, and treatment of patients with urinary incontinence in an office setting.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Primary care has become a major focus of health care reform. To create the most effective delivery of primary care services by nurse practitioners (NPs), researchers, clinicians, and administrators must continue to develop knowledge about the structure, process, and outcomes of NP primary care patient encounters. Few measures of NP-patlent care encounters exist. This exploratory study examines a method of investigating NP practice and a description of the process of NP primary care. The Nurse Practitioner Rating Form (NPRF) was used to analyze 20 videotaped NP visits with Latino clients in a primary care setting. Major findings are that NPs spent visit time engaged in assessment (61%), management (29%), and charting, consultation, and other (10%). The content or focus of the majority of NP time during visits (90%) was directed to existing physical problems. NPs received high scores for communication style and degree of client participation. Problems with using the NPRF are noted and key recommendations are made to enhance NP care and Improve investigation of primary care practice.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Currently available as a dietary supplement, the pineal hormone melatonln is portrayed by the media as a formidable weapon against disease and aging. Accordingly, primary health care providers should be cognizant of which of its proposed uses are supported by biomedical research and which are, as yet, un-proven. Melatonin entrains circadlan rhythms and, thus, can treat jet lag, delayed sleep phase syndrome, and sleep disorders in the blind and in some neurologically Impaired children. By virtue of its hypnotic effect, melatonin can mitigate Insomnia in the elderly. Reductions In melatonin secretion have been associated with many disorders, including cardiovascular disease, Alzheimer's, diabetes, SIDS, and aging; however, melatonln's role in their etiology and/or pathophysiology is unproven. Preliminary studies suggest a possible adjuvant therapeutic role for melatonin In cancer therapy. Melatonin secretion is reduced by alcohol, caffeine, and some commonly prescribed drugs. Since tolerance, fatigue, and other side effects have been reported, melatonin use on consecutive nights should be avoided and only the lowest effective hypnotic dose should be taken.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

More than 1 million women In the United States are reported to have pelvic Inflammatory disease (PID). Of these women, 70% are under 25 years of age. ‘Many cases go unreported and often are unrecognized, especially in 11’ to 15-year-old adolescents. The presentation of PID can be a diagnostic challenge for the clinician. Many clinicians assert that a diagnosis of PID In an adolescent Is an indication for hospitallzatlon, simply because of the high rate of noncompllance with a two-drug regimen In this age group. However, many health care plans no longer support hospltalization for uncomplicated PID. This article presents an overview of the risk factors, range of presenting symptoms, diagnostic methods, and criteria. Treatment and follow-up guidelines are discussed, along with issues related to patient compliance with various regimens. A sample contract for use with adolescent clients In an attempt to improve compliance is also provided. The article includes case studies that typify common presentations.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Suicide, HIV Infection, violent victimization, homelessness, and substance use are known to affect gay (gay males, lesbians, and bisexual persons of both genders) youths at disproportionately high rates. This article explores the difficulties gay youths experience In this society specific to their sexual orientation. These difficulties become Internalized by many gay youths, leading to high rates of preventable morbidities and mortalities. Stages of the “coming out” process for gay persons are reviewed within the framework of child and adolescent development. Barriers within the health care system, as well as within other social systems, specific to gay youths are examined. Such barriers include language use by the provider, sexual and social history questions asked by the provider, environmental images in the health care setting, and the responses of the provider to the adolescent. Strategies such as the use of gender-neutral wording, homosexual inclusive questioning In history taking, and the use of inclusive environmental clues to allow gay adolescents to feel safe and accepted are discussed. Health care providers are encouraged to employ such strategies to help reduce these barriers within various health care settings.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID