ABSTRACT
Registered nurses on a medical unit questioned whether current practice adequately met the emotional needs of patients with chronic obstructive pulmonary disease hospitalized for acute dyspnea. The unit's education committee surveyed nursing staff regarding priority nursing activities during dyspneic episodes. After discussion with staff development educators, several registered nurses met with the center's nurse researcher, formed a research team, and designed a descriptive study. Findings of the study gave evidence for clinical practice change and revision of care guidelines.
Subject(s)
Dyspnea/nursing , Education, Nursing, Continuing/organization & administration , Evidence-Based Medicine , Nursing Evaluation Research , Nursing Staff, Hospital/education , Pulmonary Disease, Chronic Obstructive/complications , Acute Disease , Attitude of Health Personnel , Attitude to Health , Benchmarking , Clinical Competence , Diffusion of Innovation , Dyspnea/etiology , Dyspnea/psychology , Evidence-Based Medicine/education , Evidence-Based Medicine/organization & administration , Health Services Needs and Demand , Holistic Health , Humans , New England , Nurse's Role/psychology , Nurse-Patient Relations , Nursing Assessment , Nursing Evaluation Research/education , Nursing Evaluation Research/organization & administration , Nursing Staff, Hospital/psychology , Patient-Centered Care , Practice Guidelines as Topic , Professional Staff Committees/organization & administration , Research Design , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
Within the context of Rosenbaum's theory of learned resourcefulness, this correlational study examined the relationships among family functioning, self-esteem, and resourceful coping in Thai adolescents with asthma. A convenience sample of 132 Thai adolescents (aged 12-17 years) with asthma was recruited from the outpatient asthma clinics of four hospitals in Bangkok. Self-administered questionnaires included an assessment of demographic information and asthma status, the revised Family APGAR, the Rosenberg Self-Esteem Scale, and the Children's Self-Control Scale. Hierarchical multiple regression analysis was used to examine the relationships among variables. Effective family functioning had a significant positive effect on self-esteem (beta = .27, p < .01) and resourceful coping (beta = .30, p < .01), controlling for gender and age. However, self-esteem was not significantly correlated with resourceful coping (beta = .15, p = .08). The findings suggest that nursing interventions should take into account the role of family functioning in promoting self-esteem and resourceful coping in Thai adolescents with asthma. Recommendations for future research include replication of the study with a larger sample of adolescents with asthma and with adolescents with other chronic illnesses.
Subject(s)
Adaptation, Psychological , Asthma , Attitude to Health/ethnology , Family Health/ethnology , Psychology, Adolescent , Adolescent , Adolescent Behavior/ethnology , Analysis of Variance , Asthma/ethnology , Asthma/prevention & control , Child , Factor Analysis, Statistical , Female , Health Knowledge, Attitudes, Practice , Health Promotion , Humans , Male , Models, Psychological , Nurse's Role , Nursing Methodology Research , Outpatient Clinics, Hospital , Regression Analysis , Severity of Illness Index , Surveys and Questionnaires , ThailandABSTRACT
Like pain, dyspnea, or difficulty in breathing, is a strong subjective experience of physiologial distress. Using a model developed by DeVito, this study focused on the emotional aspects of the acute experience of dyspnea in patients diagnosed with chronic obstructive pulmonary disease (COPD) on a medical unit and explored nursing activities that eased the intensity of the symptoms. The study was descriptive in design and used a semistructured interview format with four open-ended questions and a numerical self-assessment of dyspnea using the Modified 0-10 Borg Scale (MBS). The sample included 41 hospitalized patients with COPD between the ages of 43 and 89 years who had experienced episodes of acute dyspnea both prior to and during their current inpatient stays. This article provides descriptions of the experience of dyspnea, identifies themes from the participants' responses, notes the patients'perceptions of the efficacy of nursing actions, and extends the use of the MBS to an inpatient population.
Subject(s)
Dyspnea/nursing , Dyspnea/psychology , Emotions , Holistic Nursing , Pulmonary Disease, Chronic Obstructive/complications , Acute Disease , Adult , Aged , Aged, 80 and over , Dyspnea/etiology , Female , Humans , Male , Middle AgedABSTRACT
Screening for persons who are victims of domestic violence is not routinely done in emergency departments (EDs) when clients present for care, nor have all health care professionals been educated in ways to ask appropriate questions to assess victimization. Since questions to identify domestic violence are not on admission sheets and documentation is inconsistent, an interdisciplinary team in the ED of an urban medical center conducted a study using five screening questions. Findings revealed inaccurate statistics for domestic violence and significant barriers for staff participation in screening of adult clients. Clinical implications and follow-up educational programs are discussed.
