Temporal artery temperature measurements in healthy infants, children, and adolescents.
Female; Male; Ohio; Child; Infant; Analysis of Variance; Confidence Intervals; Temporal Arteries; Human; Convenience Sample; Descriptive Research; Descriptive Statistics; Funding Source; Data Analysis Software; Adolescence; Blacks; Whites; Preschool; Newborn; Body Temperature Determination – In Adolescence; Body Temperature Determination – In Infancy and Childhood
Roy S; Powell K; Gerson L W
Clinical pediatrics
2003
2003-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/000992280304200508" target="_blank" rel="noreferrer noopener">10.1177/000992280304200508</a>
Do elder emergency department patients and their informants agree about the elder's functioning?
Female; Male; Aged; Analysis of Variance; Self Report; Confidence Intervals; Human; Convenience Sample; Questionnaires; Cross Sectional Studies; Descriptive Statistics; Two-Tailed Test; T-Tests; Geriatric Functional Assessment; Significant Other; Emergency Service – Utilization – In Old Age
OBJECTIVE: To compare elder patients' and their informants' ratings of the elder's physical and mental function measured by a standard instrument, the Medical Outcomes Study Short Form 12 (SF-12). METHODS: This was a randomized, cross-sectional study conducted at a university-affiliated community teaching hospital emergency department (census 65,000/year). Patients \textgreater69 years old, arriving on weekdays between 10 AM and 7 PM, able to engage in English conversation, and consenting to participate were eligible. Patients too ill to participate were excluded. Informants were people who accompanied and knew the patient. Elder patients were randomized 1:1 to receive an interview or questionnaire version of the SF-12. The questionnaire was read to people unable to read. Two trained medical students administered the instrument. The SF-12 algorithm was used to calculate physical (PCS) and mental (MCS) component scores. Oral and written versions were compared using analysis of variance. The PCS and MCS scores between patient-informant pairs were compared with a matched t-test. Alpha was 0.05. RESULTS: One hundred six patients and 55 informants were enrolled. The patients' average (+/-SD) age was 77 +/- 5 years; 59 (56%; 95% CI = 46% to 65%) were women. There was no significant difference for mode of administration in PCS (p = 0.53) or MCS (p = 0.14) scores. Patients rated themselves higher on physical function than did their proxies. There was a 4.1 (95% CI = 99 to 7.2) point difference between patients' and their proxies' physical component scores (p = 0.01). Scores on the mental component were quite similar. The mean difference between patients and proxies was 0.49 (95% CI = 3.17 to 4.16). The half point higher rating by patients was not statistically significant (p = 0.79). CONCLUSIONS: Elders' self-ratings of physical function were higher than those of proxies who knew them. There was no difference in mental function ratings between patients and their proxies. Switching from informants' to patients' reports in evaluating elders' physical function in longitudinal studies may introduce error.
Gerson L W; Blanda M; Dhingra P; Davis J M; Diaz S R
Academic Emergency Medicine
2001
2001-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/j.1553-2712.2001.tb00191.x" target="_blank" rel="noreferrer noopener">10.1111/j.1553-2712.2001.tb00191.x</a>
Correlation of noninvasive cerebral oximetry with cerebral perfusion in the severe head injured patient: a pilot study.
Adult; Female; Male; Prospective Studies; Confidence Intervals; Human; Convenience Sample; Chi Square Test; Data Analysis Software; Pilot Studies; Middle Age; Fisher's Exact Test; Pearson's Correlation Coefficient; T-Tests; Oximetry; Monitoring; Linear Regression; Tissue Perfusion; Intracranial Pressure; Head Injuries – Therapy
BACKGROUND: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in trauma patients. Cerebral perfusion pressure (CPP) directed ICU management is recommended for patients with severe TBI. It, however, requires an invasive device to measure intracranial pressure (ICP). Transcranial cerebral oximetry is a noninvasive method utilizing near-infrared technology to indirectly measure cerebral saturation (StCO2). METHODS: A prospective observational study was performed at a Level I trauma center. Data were collected hourly for the first 6 days on four patients with severe TBI. Each patient had ICP monitoring and StCO2 (INVOS, Somanetics) assessed from each frontal lobe. CPP directed care was used. RESULTS: Four patients with TBI, with admission GCS scores of 4, 4, 7, and 8, all had subdural hematomas and contusions; three had subarachnoid hemorrhage (SAH); one had an epidural hematoma (the only death; day 6); two had craniotomies. In the first 48 hours when CPP \textgreater or = 70, StCO2 was 71 +/- 9, while it was 61 +/- 9 when CPP \textless 70 (p \textless 0.0001). This relationship was constant for all study days, with p \textless 0.0001. Moreover, CPP \textless 70 correlated with StCO2 with r = 0.8l and r(2) = 0.66. StCO2 \textgreater or = 75 was associated with CPP \textgreater or = 70 96.4% of the time (95% CL, 94.3-98.5%). StCO2 \textless 55 was associated with CPP \textless 70 68.2% of the time (95% CL, 57-79.4%). Also, 13.4% of observations with CPP \textgreater or = 70 had StCO2 \textless 60, suggesting the potential of cerebral ischemia in the face of 'normal' CPP. The StCO2 patches were user-friendly and not technically finicky. CONCLUSION: In this pilot study, StCO2 correlated significantly with CPP. A StCO2 \textgreater or = 75 suggests that CPP is adequate, while \textless 55 suggests an inadequate CPP. Although these results should be confirmed in a larger study, StCO2 may serve as a noninvasive measurement of cerebral perfusion in the patient with a TBI or, at the very least, a sensitive indicator for the need to begin monitoring the ICP.
Dunham CM; Sosnowski C; Porter J M; Siegal J; Kohli C
Journal of Trauma
2002
2002-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/00005373-200201000-00009" target="_blank" rel="noreferrer noopener">10.1097/00005373-200201000-00009</a>
The medically underserved: who is likely to exercise and why?
Adult; Female; Male; Ohio; Aged; Motivation; Exercise; Health Promotion; Counseling; Human; Convenience Sample; Questionnaires; Chi Square Test; Descriptive Statistics; Funding Source; Data Analysis Software; Interviews; Middle Age; Correlation Coefficient; Adolescence; Summated Rating Scaling; Whites; Preventive Health Care; Medically Underserved – Ohio
Adults who exercise regularly have better health, but only 15% of U.S. adults engage in regular exercise, with some social groups, such as people with lower incomes and women, having even lower rates. This study investigates the rate at which medically underserved patients receive exercise counseling from health care providers, characteristics of those who exercise, and barriers and motivations to exercise. The convenience sample was predominantly female and White and exclusively low-income and uninsured or underinsured. On average, participants were obese, by Federal Obesity Guidelines; 43% smoked. Although 60% of 126 patients reported that providers discussed exercise with them, the discussions had no relationship with patients' engagement in exercise. Women and those with lung problems, diabetes, or children in the home were less likely than others surveyed to exercise. The highest rated motivations included body image and health issues. The most important barriers were time, cost, and access to exercise facilities and equipment. In order for exercise counseling to be more effective, health care providers' interventions must consider patients' personal characteristics, health status, readiness to engage in an exercise program, and motivations and barriers to exercise.
Schrop S L; Pendleton BF; McCord G; Gil K M; Stockton L; McNatt J; Gilchrist V J
Journal of Health Care for the Poor & Underserved
2006
2006-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1353/hpu.2006.0069" target="_blank" rel="noreferrer noopener">10.1353/hpu.2006.0069</a>
Does functional decline prompt emergency department visits and admission in older patients?
Female; Male; Ohio; Aged; Prospective Studies; Hospitals; Activities of Daily Living; Confidence Intervals; Human; Convenience Sample; Questionnaires; Cross Sectional Studies; Descriptive Statistics; Funding Source; Data Analysis Software; Surveys; Coefficient Alpha; Clinical Assessment Tools; Emergency Service; Community; Geriatric Functional Assessment; 80 and Over; Emergency Care – In Old Age; Functional Status – In Old Age; Health Resource Utilization – In Old Age; Patient Admission – In Old Age
BACKGROUND: Older patients may visit the emergency department (ED) when their illness affects their function. OBJECTIVES: To quantify the function of older ED patients, to assess whether functional decline (FD) had occurred, and to determine whether function contributes to the ED visit and hospital admission. METHODS: The authors performed an institutional review board-approved, prospective, cross-sectional study in a community teaching hospital ED. Eligible patients were older than 74 years of age, with an illness at least 48 hours old. Patients from a nursing facility and those without a proxy who were unable or unwilling to complete the questions were excluded. The Older Americans Resources and Services Questionnaire, which tests seven instrumental activities of daily living (IADL) and seven physical ADLs (PADL), was used. Data are presented as means or proportions with 95% confidence intervals (95% CI), and comparisons as 95% CI for the difference between proportions. RESULTS: The authors enrolled 90 patients (mean age, 81.6 yr [SD +/- 4.9], 40% male). Dependence in at least one IADL was reported by 68% (95% CI = 57% to 77%), and in at least one PADL by 61% (95% CI = 50% to 71%). Functional decline was reported by 74% (95% CI = 64% to 83%). Two thirds of those with IADL decline and three quarters of those with PADL decline said that this contributed to their ED visit. Seventy-seven percent with, and 63% without, IADL decline were admitted (14% difference, 95% CI = -6.1% to 33%). Seventy-nine percent with and 61% without PADL decline were admitted (18% difference, 95% CI = -1.4% to 38%). CONCLUSIONS: Functional decline is common in older ED patients and contributes to ED visits in older patients; its role in admission is unclear.
Wilber S T; Blanda M; Gerson L W
Academic Emergency Medicine
2006
2006-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1197/j.aem.2006.01.006" target="_blank" rel="noreferrer noopener">10.1197/j.aem.2006.01.006</a>
A broader understanding of care managers' attitudes of advance care planning: A concurrent nested design.
*Attitude of Health Personnel; *Health Knowledge; Adult; Advance Care Planning; Advance Care Planning/*standards; Attitudes; Case Managers; Chi Square Test; community health; Concurrent Prospective Studies; Convenience Sample; decision-making; Discussion; end of life; Female; Focus Groups; Funding Source; Health Services Accessibility/standards; Human; Humans; Male; Middle Age; Middle Aged; Midwestern United States; Multicenter Studies; Multimethod Studies; Nurse Attitudes; nurses; Practice; qualitative; Qualitative Research; quantitative; Questionnaires; Surveys; Surveys and Questionnaires; Thematic Analysis
AIMS AND OBJECTIVES: To examine barriers of advance care planning (ACP) experienced by care managers (CMs) through a mixed methods approach. A concurrent nested design was used to acquire a deeper understanding of ACP and to identify nuances between quantitative and qualitative data. BACKGROUND: Past quantitative studies on providers have identified barriers related to time, culture, knowledge, responsibility and availability of legal documents. These barriers, and accompanying attitudes and feelings, have been taken at face value without rich qualitative data to identify under what conditions and to what extent a barrier impacts care. DESIGN: A two-part multisite, mixed methods study was conducted using surveys and focus groups. METHODS: Surveys were completed by 458 CMs at 10 Area Agencies on Aging and 62 participated in one of eight focus groups. Data were analysed using a concurrent nested design with individual data analysis and a merged data approach. RESULTS: There were three main distinctions between the quantitative and qualitative data. First, while CMs reported on the survey that ACP was not too time consuming, focus group data revealed that time was an issue especially related to competing priorities. Second on the survey 60% of the CMS reported they had enough knowledge, but qualitative data revealed about more nuances. Last, the reported comfort levels in the quantitative data were less overt in the qualitative date where additional feelings and attitudes were revealed, for example, frustration with families, preferences for more physician involvement. CONCLUSIONS: Care managers reported their attitudes about ACP, clarified through a rigorous mixed methods analysis. Care managers can successfully lead ACP discussions, but require further education, resources and team-based guidance. RELEVANCE TO CLINICAL PRACTICE: Advance care planning is essential for reducing emotional, social and financial burdens associated with healthcare decision-making, and CMs can positively impact ACP discussions when appropriately supported by the clinical community. The many nuances in the ACP process that we found illustrate the need for ongoing discussions, education and research on this important topic.
Aultman Julie; Baughman Kristin R; Ludwick Ruth
Journal of clinical nursing
2018
2018-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/jocn.14531" target="_blank" rel="noreferrer noopener">10.1111/jocn.14531</a>
Surveying the hidden attitudes of hospital nurses' towards poverty.
*Attitude of Health Personnel; *Healthcare Disparities; *Poverty; Adult; Age Factors; Attitude Measures; attitudes; Coefficient Alpha; Convenience Sample; Cross Sectional Studies; Cross-Sectional Studies; Descriptive Research; Descriptive Statistics; Educational Status; Female; health disparities; health inequities; Health Status Disparities; Hospital; Hospital/*psychology; Human; Humans; Income; Job Experience; Male; Middle Age; Middle Aged; Multivariate Analysis; Nurse Attitudes – Evaluation; nurses; Nursing Staff; Ohio; Politics; poverty; Poverty; Registered Nurses; Regression; Regression Analysis; Summated Rating Scaling; Surveys and Questionnaires; Young Adult
AIMS AND OBJECTIVES: To explore the attitudes held by registered nurses about persons living in poverty. BACKGROUND: As a profession, nursing has strong commitment to advocating for the socioeconomically disadvantaged. The links among poverty and health disparities are well established and research demonstrates that attitudes of providers can influence how those in poverty use health services. Although nurses are the largest sector of healthcare providers globally, little research has been published on their attitudes towards patients they care for who live in poverty. DESIGN: Cross-sectional survey. METHODS: Used a convenience sample of 117 registered nurses who completed the Attitudes Towards Poverty Short Form that contained three subscales. Regression analysis was used to examine the associations between the nurses' age, education, and years of experience, political views and financial security with their total score and subscale scores. RESULTS: Nurses were more likely to agree with stigmatising statements than statements that attributed poverty to personal deficiency or structural factors. In the multivariate analysis, years of experience were associated with more positive attitudes towards those living in poverty. Nurses with the most experience had less stigmatising beliefs about poverty and were more likely to endorse structural explanations. Those with a baccalaureate education were also more likely to endorse structural explanations for poverty. CONCLUSIONS: Gaining knowledge about attitudes towards and the factors influencing those attitudes, for example, education, are important in helping combat the disparities associated with poverty. RELEVANCE TO CLINICAL PRACTICE: Nurses have a duty to evaluate their individual attitudes and biases towards those living in poverty and how those attitudes and biases may influence daily practice. Assessing nurses' attitudes towards poverty may aid in better means of empowering nurses to seek solutions that will improve health conditions for those living in poverty.
Wittenauer James; Ludwick Ruth; Baughman Kristin; Fishbein Rebecca
Journal of clinical nursing
2015
2015-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/jocn.12794" target="_blank" rel="noreferrer noopener">10.1111/jocn.12794</a>
Willingness and Ability of Older Adults in the Emergency Department to Provide Clinical Information Using a Tablet Computer.
*aged; *Attitude to Computers; *Computers; *data collection; *elderly; *emergency department; *Emergency Service; 80 and over; 80 and Over; ACADEMIC medical centers; Academic Medical Centers – North Carolina; Aged; Computers; Confidence Intervals; CONFIDENCE intervals; Convenience Sample; Cross Sectional Studies; CROSS-sectional method; Cross-Sectional Studies; Descriptive Statistics; DESCRIPTIVE statistics; Emergency Care – In Old Age; EMERGENCY medical services; Emergency Service; Female; Handheld; Hospital; HOSPITAL emergency services; Human; Humans; LONGITUDINAL method; Male; Mass Screening/*instrumentation; MEDICAL cooperation; Multicenter Studies; New Jersey; NEW Jersey; North Carolina; NORTH Carolina; OLD age; Patient Attitudes – Evaluation – In Old Age; PATIENTS' attitudes; Portable – Utilization – In Old Age; PORTABLE computers; Prospective Studies; RESEARCH; SCALE analysis (Psychology); Scales; STATISTICAL sampling; Summated Rating Scaling; Surveys and Questionnaires; United States; User-Computer Interface
OBJECTIVES: To estimate the proportion of older adults in the emergency department (ED) who are willing and able to use a tablet computer to answer questions. DESIGN: Prospective, ED-based cross-sectional study. SETTING: Two U.S. academic EDs. PARTICIPANTS: Individuals aged 65 and older. MEASUREMENTS: As part of screening for another study, potential study participants were asked whether they would be willing to use a tablet computer to answer eight questions instead of answering questions orally. A custom user interface optimized for older adults was used. Trained research assistants observed study participants as they used the tablets. Ability to use the tablet was assessed based on need for assistance and number of questions answered correctly. RESULTS: Of 365 individuals approached, 248 (68%) were willing to answer screening questions, 121 of these (49%) were willing to use a tablet computer; of these, 91 (75%) were able to answer at least six questions correctly, and 35 (29%) did not require assistance. Only 14 (12%) were able to answer all eight questions correctly without assistance. Individuals aged 65 to 74 and those reporting use of a touchscreen device at least weekly were more likely to be willing and able to use the tablet computer. Of individuals with no or mild cognitive impairment, the percentage willing to use the tablet was 45%, and the percentage answering all questions correctly was 32%. CONCLUSION: Approximately half of this sample of older adults in the ED was willing to provide information using a tablet computer, but only a small minority of these were able to enter all information correctly without assistance. Tablet computers may provide an efficient means of collecting clinical information from some older adults in the ED, but at present, it will be ineffective for a significant portion of this population.
Brahmandam Sruti; Holland Wesley C; Mangipudi Sowmya A; Braz Valerie A; Medlin Richard P; Hunold Katherine M; Jones Christopher W; Platts-Mills Timothy F
Journal of the American Geriatrics Society
2016
2016-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/jgs.14366" target="_blank" rel="noreferrer noopener">10.1111/jgs.14366</a>
Analysis of the Pressure Distribution Qualities of a Silicone Border Foam Dressing.
*Bandages; *Pressure; *Silicones; Adult; Body Mass Index; Comparative Studies; Convenience Sample; Data Analysis Software; Descriptive Statistics; Female; Foam Dressings; Heel; Heel – Pathology; Human; Humans; Interface Pressure; Male; Middle Age; Models; Ohio; P-Value; Pearson's Correlation Coefficient; Pressure Ulcer – Prevention and Control; Pressure Ulcer/prevention & control; Prospective Studies; Regression; Silicones; Statistical; Supine Position; Surveys; T-Tests
PURPOSE: To determine whether application of a silicone foam dressing is associated with decreased interface pressures when applied to the heel. DESIGN: Prospective, within-subjects design. SUBJECTS AND SETTING: The study was conducted in a community-based hospital using a convenience sample of 50 healthy volunteers with a mean age of 39.6 years and mean body mass index of 26.6; 70% were female. METHODS: Application of the silicone border foam dressing was randomized between the left and right heels. Participants were asked to lie down in the supine position on a viscoelastic foam mattress. Interface pressure measurements were captured using a pressure mapping system; measurements were taken once with the dressing applied to the heel (intervention map) and once without (control map). Data were captured after a 4-minute time period allowing stabilization. Analysis was based on mean interface pressure; data points were collected for both heels in each of the 2 frames, yielding 4 observations per subject. RESULTS: Application of the dressing was associated with a significant decrease in average pressure measurements as compared to the heel with no dressing applied (P \textless .001). Application of the dressing did not impact pressure readings for the heel to which no dressing was applied (P = .53), and application of the dressing to either the left or right heel did not impact pressure readings (ie, the random effect was insignificant; P = .9). CONCLUSIONS: Application of a silicone border foam dressing is associated with significant reduction in interface pressure and may be considered as part of a pressure ulcer prevention program.
Miller Stephannie K; Sharma Neal; Aberegg Lauren C; Blasiole Kimberly N; Fulton Judith A
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society
2015
2015-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/WON.0000000000000130" target="_blank" rel="noreferrer noopener">10.1097/WON.0000000000000130</a>
Development of a Nutrition Screening Tool for an Outpatient Wound Center.
*Nutrition Assessment; Adult; Ambulatory Care Facilities; Ambulatory Care/*methods; Bivariate Statistics; Convenience Sample; Descriptive Statistics; Human; Humans; Logistic Regression; Malnutrition – Risk Factors; Malnutrition/*diagnosis/etiology; Mass Screening/*methods; Nutrition; Nutritional Status; Ohio; Outcome Assessment (Health Care); Outpatients/*statistics & numerical data; Pilot Projects; Pilot Studies; Prospective Studies; Reliability and Validity; Wound Care; Wounds and Injuries/complications
OBJECTIVE: To construct a quickly and easily administered nutrition screening tool using variables believed to be predictive of malnutrition risk in the wound patient population. DESIGN: A prospective pilot study assessed patients on a list of suspected variables, as well as the Scored Patient-Generated Subjective Global Assessment (PG-SGA), chosen as the criterion standard. Variables were analyzed to select the most appropriate items for inclusion on a new nutrition screening tool using preliminary bivariate correlations and chi tests of association. Items significantly associated with malnutrition were dichotomized, and binary logistic regression analyses were performed to arrive at a final model. A sum score was computed, and receiver operating characteristic analysis was used to determine designation of risk. SETTING: An outpatient wound center in Northeast Ohio. PARTICIPANTS: The pilot study included a convenience sample of 105 outpatients with at least 1 active wound. MAIN OUTCOME MEASURES: Malnutrition as assessed by the Scored PG-SGA. MAIN RESULTS: The final nutrition screening tool, the MEAL Scale, is composed of 4 dichotomous elements: multiple wounds (number of wounds), eats less than 3 meals per day, appetite decrease (eats less than usual), and level of activity. These variables predicted 83.7% of the malnutrition cases assessed by the Scored PG-SGA. The receiver operating characteristic analysis showed an acceptable area under the curve (0.8581), and a cutoff score of 2 or greater was selected to indicate risk (median sensitivity = 91.4%, median specificity = 60.9%). CONCLUSIONS: Although further studies of validity and reliability are necessary to establish the tool before widespread use, the MEAL Scale is a needed step toward nutrition screening in a wound patient population.
Fulton Judith; Evans Brad; Miller Stephannie; Blasiole Kimberly N; Leone Raymond; Beinlich Nancy; Meehan Anita; Loose Claire
Advances in Skin & Wound Care
2016
2016-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/01.ASW.0000479803.09658.cb" target="_blank" rel="noreferrer noopener">10.1097/01.ASW.0000479803.09658.cb</a>
Mindfulness as a predictor of positive reappraisal and burnout in standardized patients.
*Adaptation; *Emotions; *Patient Satisfaction; 80 and over; Adult; Aged; Burnout; Clinical Assessment Tools; Coefficient Alpha; Convenience Sample; Descriptive Statistics; Education; Female; Human; Humans; Job Characteristics; Male; Medical; Middle Aged; Mind Body Techniques; Models; Multiple Regression; Ohio; Patient Simulation; Professional – Risk Factors; Psychological; Psychological/*complications/psychology; Psychometrics; Questionnaires; Regression Analysis; Risk Assessment; Statistics as Topic; Stress; Summated Rating Scaling
BACKGROUND: Standardized patients (SPs) portray emotionally intense roles that can have unintended deleterious effects including burnout. PURPOSE: This study explored SP characteristics that could serve as protective factors against these adverse effects. The literature suggests that positive reappraisal and mindfulness are protective factors, with positive reappraisal mediating the relationship between mindfulness and burnout. METHODS: Seventy-six SPs completed an instrument measuring burnout, positive reappraisal, and mindfulness. Multiple regression was performed to test the hypothesized mediator model. RESULTS: The results revealed that mindfulness and positive reappraisal explained a meaningful portion of SP burnout variance (R (2) = .31 p \textless .01). Germane to the mediator model, all correlations were significant: mindfulness and positive reappraisal (a) r = .668; positive reappraisal and burnout (b) r = -.527; and mindfulness and burnout (c) r = -.496, p \textless 01. When positive reappraisal and mindfulness were included in the model, the previously significant relationship c was no longer statistically significant. The combination of these three relationships supports a mediator model. CONCLUSIONS: Education to enhance mindfulness and positive reappraisal offers a way to offset the adverse effects of portraying intense emotional patient experiences.
Gerzina Holly A; Porfeli Erik J
Teaching and learning in medicine
2012
2012
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/10401334.2012.715255" target="_blank" rel="noreferrer noopener">10.1080/10401334.2012.715255</a>
Managing in the trenches of consumer care: the challenges of understanding and initiating the advance care planning process.
*Health Personnel/psychology/standards; *Health Services for the Aged; *Long-Term Care/methods/organization & administration/psychology; *Patient Care Management/methods/organization & administration; Advance Care Planning; Advance Care Planning/*organization & administration; Attitude of Health Personnel; Case Management; Convenience Sample; Decision Making; Family Relations; Focus Groups; Funding Source; Human; Humans; Interpersonal Relations; Long Term Care; Needs Assessment; Nurse Attitudes; Ohio; Patient Education as Topic; Professional Role; Professional-Patient Relations; Qualitative Research; Qualitative Studies; Social Work/*standards; Social Worker Attitudes; Terminal Care/organization & administration/psychology; Thematic Analysis
To better understand how community-based long-term care providers define advance care planning and their role in the process, we conducted 8 focus groups with 62 care managers (social workers and registered nurses) providing care for Ohio's Medicaid waiver program. Care managers shared that most consumers had little understanding of advance care planning. The care managers defined it broadly, including legal documentation, social aspects, medical considerations, ongoing communication, and consumer education. Care managers saw their roles as information providers, healthcare team members, and educators/coaches. Better education, resources, and coordination are needed to ensure that consumer preferences are realized.
Baughman Kristin R; Aultman Julie; Hazelett Susan; Palmisano Barbara; O'Neill Anne; Ludwick Ruth; Sanders Margaret
Journal of gerontological social work
2012
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/01634372.2012.708389" target="_blank" rel="noreferrer noopener">10.1080/01634372.2012.708389</a>
Ultrasound-assisted internal jugular vein catheterization in the ED.
*Emergency Treatment; *Jugular Veins; Catheter Placement Determination; Catheterization; Central Venous; Central Venous/adverse effects/*methods; Clinical Competence; Convenience Sample; Descriptive Statistics; Emergency Care; Emergency Service; Hematoma/etiology; Hospital; Hospital/education; Human; Humans; Interventional/adverse effects/*methods; Jugular Veins – Ultrasonography; Medical Staff; Patient Selection; Prospective Studies; Record Review; Treatment Outcomes; Ultrasonography
A prospective, descriptive study is reported on the use and success of ultrasound-assisted internal jugular central vein catheterization (CVC) in the emergency department (ED). In patients not in cardiac arrest who had an indication for internal jugular CVC, lines were placed by trained ED staff using ultrasound. Data were collected prospectively on age, sex, body habitus, indication, vein visibility, number of punctures and needle passes, and success. There were 40 attempts at internal jugular CVC in 34 patients and ultrasound was used in 32 of the 40 (80%) attempts. Incidences of successful puncture and cannulation using ultrasound were 93.8% (30 of 32) and 81.3% (26 of 32), respectively, compared with 62.5% (5 of 8) and 62.5% (5 of 8) in the landmark group. In 8 patients with no visual or palpable landmarks, cannulation was successful in 100% (7 of 7) using ultrasound and in 0% (0 of 1) using landmark technique. Ultrasound-assisted internal jugular CVC is an easily learned technique that is useful in the ED. It may be especially helpful in patients in whom landmarks are not visible and not palpable.
Hrics P; Wilber S; Blanda M P; Gallo U
The American journal of emergency medicine
1998
1998-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s0735-6757(98)90140-1" target="_blank" rel="noreferrer noopener">10.1016/s0735-6757(98)90140-1</a>