ISSN:0361-1817    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study of an elderly population examined the prevalence of advance directives, the barriers to documentation, and the relation of anxiety to advance directives. Elders (mean age 77.7 years) residing in a nursing home comprised the convenience sample (n = 104). Data were obtained by record review for the total sample, and personal interviews with 17 residents. Descriptive statistics and the x2-test of proportions were employed for analysis. The prevalence of documentation was 51.9% (n = 104), including 35 do-not-resuscitate orders, 17 health care powers of attorney, 16 medical directives, and 13 living wills; 18 records contained more than one directive. Those interviewed, both with and without advance directives, revealed low death anxiety (Templer's Death Anxiety Scale), reminiscing freely about their lives and experiences. Barriers suggested by the self-reports were misconceptions, little knowledge, opportunity, or interest in preparing directives, and the belief that clinicians or family were responsible for end-of-life decisions.

ISSN:0361-1817    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Coronary heart disease (CHD) remains the number one killer in the United States. This article summarizes the recommendations for cholesterol screening of children and adolescents by the American Academy of Pediatrics and the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Screening of children and adolescents is selective, and the determination to screen is based on past medical, family health, and health behavior histories. Children or adolescents with a family history of peripheral vascular disease or coronary artery disease in primary relatives under 55 years of age, or parents with high blood cholesterol levels, are considered to be at risk for high blood cholesterol and in need of screening. Children or adolescents who are obese, inactive, have hypertension or diabetes, or who smoke are also considered to be at risk. A universal approach to the prevention of CHD through diet and lifestyle is also described.

ISSN:0361-1817    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Urinary discomfort is the second most common physical complaint affecting women. Although urinary discomfort is commonly a result of inflammation due to bacterial invasion, there are also nonbacterial causes. The development of antimicrobial resistance to bacteria is frequent and costs the patient and the medical community unnecessary time and money. Antimicrobial intervention should be instituted only after the uropathogen is identified through a urine culture. While awaiting the results of the urine culture or other laboratory or radiological tests, the patient's symptoms can be relieved with the use of urinary analgesics or antispasmodics. This conservative approach meets the Immediate concern of the patient and better ensures a proper diagnostic workup and successful cure. Along with a conservative diagnostic approach, the patient should be included in all aspects of health care management.

ISSN:0361-1817    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Recurrent urinary tract infections (UTIs) are common, but clinicians unfamiliar with the natural history or pathogenesis may order unnecessarily expensive tests and provide unsubstantiated advice to their patients. A large body of literature indicates that recurrent UTIs do not progress to permanent kidney damage or end-stage renal disease. The vast number of UTIs are due to the interplay between minor weaknesses in host defenses and bacterial virulence factors. Sexual intercourse and diaphragm/spermlcide use are the two behavioral factors most consistently associated with UTIs. Basic history, physical exam, and urinalysls are able to identify the few patients likely to benefit from Invasive urologlc work-ups, which usually have a very low yield when ordered routinely. Effective management options include daily or post-coital antimicrobial prophylaxis, or patient-initiated treatment. Patients can be reassured of an excellent prognosis. There is no evidence validating proscription of personal preferences, such as soda pop, tight clothing, or direction of perineal cleansing after defecation.

ISSN:0361-1817    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1995

数据来源: OVID