ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

On October 6, 2000, the Centers for Medicare & Medicaid Services (CMS) (formerly the Health Care Financing Administration) issued a national coverage decision for the use of biofeedback and pelvic floor electrical stimulation in the treatment of urinary incontinence. This decision was the first major health care coverage decision made using CMS's new “open” process. The new process included the use of a panel of physicians to evaluate adequacy of evidence to support the utilization of the modalities. From the very beginning, there were indications that CMS was not favorably disposed toward the use of these modalities, and there was a real threat that coverage could be withdrawn or that no decision would be made. The organized and cohesive response of the health care community influenced CMS to make a positive coverage decision. Through the diligent and tenacious work of a group of nurses called the SUNA/WOCN Continence Coalition, professional organizations and prominent individuals were brought together to approach CMS with one message and one voice.

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PurposeThe purpose of this study was to examine nurses' ratings of appropriateness of wound treatments and wound healing for patients in home care in relation to patient demographic and visit variables.DesignA cross-sectional design was used.Setting and subjectsData were collected about patients with wounds by 281 nurses from 13 home care agencies located throughout lower Michigan. Patients with wounds (n = 881) ranged in age from 21 to 100 years. They included 492 women and 383 men who were white (72.4%) or African-American (26%).InstrumentsThe Community Wound Assessment Tool was developed for the study and was used to obtain demographic and wound data. The demographic section contained information about the patient's age, sex, reason for the visit, length of visit, and time the case was opened. The wound section included the wound type, treatments, presence of incontinence, nutritional supplementation, and adverse home environmental factors. Nurses rated wounds as healing or not healing. Wound treatments were rated as all appropriate, some appropriate/inappropriate, and all inappropriate.MethodsNurses were systematically selected from each agency and collected data about each patient visited on one occasion.Main outcome measurementsThe main outcome measurements were the relationship of patient demographic variables and visit variables to the appropriateness of wound treatments and wound healing.ResultsThe nurses' rating of wound treatments as appropriate was significantly related to younger patient age and a shorter time for the case to be open. Wound healing was initially associated with younger patient age, continence of urine or stool, shorter home visits, shorter time for the case to be open, and fewer reasons for the visit. When wound healing was controlled for the type of wound in path analysis, the patient's age was no longer significant and incontinence appeared to impair healing of nonsurgical wounds. The appropriateness of the wound treatments was significantly related to wound healing.ConclusionsNurses' ratings of appropriateness of wound treatments and healing are significantly related to factors that affect length of service and complexity of care for the home care patient with a wound. Decisions nurses make about wound treatments and healing are important for the patient as well as for the agency.

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Whether to use clean or sterile technique in the management of acute and chronic wounds is a question that researchers and clinicians have been asking and attempting to answer with certainty since the 1800s. Because patient situations are unique, particularly in the home, the structured guidelines one finds for wound cleansing and dressing are not universally applicable. The key to current WOCN practice is to critically examine wound care regimens, remain current in wound care strategies, and base practice on best current evidence along with government policies.

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

One of the responsibilities of WOC nurses is to possess expert knowledge regarding the treatment and management of chronic venous insufficiency (CVI). WOC nurses must stay abreast of new approaches that are being used, such as subfascial endoscopic perforator surgery (SEPS). Patients who have repeated ulceration, even with long-term compression therapy and compliance with a good skin regimen, are excellent candidates for referral for SEPS. SEPS is a minimally invasive approach used to ligate the perforator veins in the lower extremities. This procedure is done to bypass the faulty one-way valves in the perforator veins that allow backflow into the venous system, thereby causing CVI. The published research on SEPS shows that it holds great promise as an alternative approach in the treatment of CVI. Additional studies are needed to assess the long-term efficacy of SEPS; however, it appears to be a viable option for patients who are plagued with CVI and repeated ulcerations.

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveThe purpose of this study was to investigate the relationship between family dynamics and health locus of control in families who had a member with an ostomy.DesignThe study used a cross-sectional design.Setting and subjectsData were collected by means of questionnaires completed by 2 groups of families. Twenty-nine subjects in the ostomy group were registered with a local chapter of the United Ostomy Association. Thirty subjects in the non-ostomy control group were recruited from a local church, a university housing complex, and a hospital volunteer service.InstrumentsThe Family Dynamics Measure of 62 Likert-type items measured 6 bipolar dimensions of family dynamics. The Multidimensional Health Locus of Control Scale of 18 Likert-type items measured internal or external locus of control.MethodsQuestionnaires were mailed to subjects by staff at the local ostomy association and other cooperating groups. Completed questionnaires were returned by mail to the researcher.ResultsSubjects in the ostomy group perceived significantly greater control by powerful others and greater rigidity in the family compared with the non-ostomy group. When families were perceived as rigid, both groups reported significantly greater control by powerful others. Subjects in the ostomy group who reported greater role reciprocity in the family perceived greater health locus of control by powerful others.ConclusionsHealth care professionals and family members (powerful others) play an important role in helping a person with an ostomy. Assessing family dynamics can help professionals identify which aspects of family life are associated with locus of control for the person with an ostomy.

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID