A 6-month study of low-dose recombinant human erythropoietin alone and in combination with androgens for the treatment of anemia in chronic hemodialysis patients.

Two previous short-term studies (12 weeks and up to 16 weeks) that used androgens to supplement recombinant human erythropoietin (rHuEPO) for the treatment of the anemia associated with end-stage renal disease showed divergent results. Both studies were limited by their brief duration, since the hematopoietic effect of androgens does not peak until 5 months. Therefore, we conducted a 6-month, prospective, randomized trial comparing low-dose rHuEPO alone and in combination with androgens for the treatment of the anemia of end-stage renal failure. Nineteen anemic chronic hemodialysis patients were randomized into two groups. Group A (n = 10) received 1,500 U rHuEPO intravenously three times a week for 26 weeks. Group B (n = 9) received the same dose of rHuEPO plus nandrolone decanoate 100 mg intramuscularly weekly. Baseline transferrin saturation, serum ferritin, intact serum parathyroid hormone, plasma aluminum, and hematocrit levels were not significantly different between the groups. At study completion, both groups showed a significant increase in mean hematocrit compared with baseline (group A: 24.8% +/- 1.4% to 28.3% +/- 2.8%, P = 0.003; group B: 25.1% +/- 1.5% to 33.2% +/- 4.5%, P = 0.001). The increase in hematocrit in the rHuEPO plus androgen-treated group was statistically greater than in the rHuEPO-alone group (8.2% +/- 4.4% v 3.5% +/- 2.8%; P = 0.012). With the exception of mild discomfort at the injection site, there were no significant side effects from nandrolone. We conclude that the combination of low-dose rHuEPO and nandrolone decanoate is effective treatment for the anemia of end-stage renal failure.

Senior nursing students' and professional nurses' perceptions of effective caring behaviors: a comparative study.

Care forms the basic core of nursing actions. Traditionally nurses have described the acts of administering to patients as care behaviors. Many nurses find it difficult to define these caring behaviors. It is important that nurses have insight into the specific behaviors that patients perceive to be most important. Several studies have examined and compared nurses' and patients' perceptions of effective care behaviors. The literature supports an incongruence of what nurses perceive and what patients perceive as effective. This study identifies and compares student nurses' and professional nurses' perceptions of effective caring behaviors. The Caring Assessment Report Evaluation Q-sort (CARE-Q) was used to obtain the data. The participants included senior baccalaureate nursing students (n = 30) at Thomas Jefferson University, College of Allied Health Sciences, and professional nurses (n = 30) with 1 or more years experience. The significance of the difference between the groups was tested using the Mann Whitney U test. Results indicate agreement between the students and the nurses in all categories except trusting relationship (p = .06). The ages within the groups varied from 21 to 47 years. The difference in ages between the nurses and the students is significant (p = .0002). Findings provide a better understanding of student nurse perceptions of caring behaviors and provide implications for further research for nurse educators.