摘要:

One of the best ways a nurse practitioner can make a lasting contribution is through the published word. A nurse writer publishes to inform, instruct, challenge, and inspire. This sharing of ideas is critical for professional growth and visibility. The writing process may appear at first glance to be difficult, yet the tips and techniques described in this article demonstrate that writing is a craft which can be learned. Although the process that results in a final, published manuscript may, at times, appear lengthy, the approach to preparing a manuscript is simple, requiring a modicum of skill and a strong desire to share knowledge.

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1992.tb01104.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Hyperthyroidism is an endocrine disorder encountered in adult primary care clinics. This article reviews normal thyroid physiology as well as the pathophysiology, diagnosis, clinical signs and symptoms, and diagnostic tests and treatment for the most common clinical hyperthyroid entities. Current research is also discussed as it relates to clinical practice.

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1992.tb01105.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Nurse practitioners (NP) are often confronted with female clients who describe various types of urine loss symptoms. To establish an accurate diagnosis and therapeutic intervention, it is important for the NP to identify the etiology of the urine loss complaint. The purpose of the study is to compare symptoms and physical findings that differentiate between the urodynamic diagnoses of genuine stress incontinence (GSI) and mixed incontinence (MI) in 135 clinical trial subjects: 123 diagnosed as GSI and 12 as MI. These subjects participated in a randomized controlled clinical trial to investigate the efficacy of biofeedback and pelvic floor exercises for incontinence treatment. Data were analyzed for significant differences between these two groups on urologic and gynecologic symptoms, pelvic muscle relaxation, vaginal mucosa, vaginal electromyograph readings, urodynamic parameters, and quantified measure of urine loss. One‐way analysis of variance (ANOVA) showed significant difference in nocturnal and diurnal voidings and urine loss immediately after sensing the urge to void in the MI and GSI subjects. Chi‐square analyses found a significantly decreased incidence of poor vaginal tone and atrophic vaginal mucosa in the MI group as compared to the GSI group. The MI group also lost significantly more urine than did the GSI group on the hand wash maneuver of the perineal pad test. Although the sample size of MI subjects was small, these results show that a noninvasive history and physical examination can differentiate between urologic diagnoses. This approach provides a cost‐effective expedient protocol to aid the NP in establishing a differential diagnosis between genuine stress and mixed inconti

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1992.tb01106.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Adult children of alcoholics are increasingly recognized as a population facing greater risk for developing emotional and physical problems. This article describes characteristics of adult children of alcoholics and presents a method for identifying those most at risk. Implications for practice are also discussed.

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1992.tb01107.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Understanding and learning to play the games of politics can increase the political efficiency of nurse practitioners (NPs) and assist them in advancing their roles and functioning in the crowded health care arena. One framework that can be applied to the political process is Allison's Governmental Political Model. Allison's model approaches the process of politics as competitive games. This article presents Allison's political model and demonstrates how understanding and learning to play political games has potential to promote NP political effectiveness.

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1992.tb01108.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1992.tb01109.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1992.tb01110.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In January 1992, the federal government implemented a package of physician payment reforms for use in the Medicare program. Among these reforms is a resource‐based fee schedule that replaces the customary, prevailing, and reasonable (CPR) method of payment that has been used since Medicare's inception. This article describes the recommendations of the Physician Payment Review Commission, a Congressional advisory group, concerning the implications of the resource‐based fee schedule on nurse practitioners and other non‐physician practitioners. Absent changes in current law, services provided by nurse practitioners will be paid based on the same formulas that were used under CPR. This author advises that these payment formulas be revised to reflect the differences in resource costs borne by physicians and nonphysicians. Furthermore, revisions to the payment formulas should be made in the near future before the Medicare fee schedule and the rules governing its use are adopted by other public (e.g., Medicaid) and private p

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1992.tb01111.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1992.tb01112.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1992.tb01113.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY