ABSTRACT
Although chronic pain is a frequent cause of suffering and disability and is costly to society, there continues to be limited access to specialty pain clinic services. Hence, there is a need for cost-effective, accessible interventions that will help people find ways to better manage this difficult problem. This randomized controlled trial examined the effect of a low-cost, community-based, nurse-delivered, group psychoeducation program entitled the Chronic Pain Self-Management Program (CPSMP). It has a standard protocol that was modified from the successful Arthritis Self-Management Program (ASMP). One hundred and ten individuals with mixed idiopathic chronic pain conditions were enrolled in the study (75% female; mean age 40 years; mean chronicity 6 years) and were randomly assigned to one of two conditions: the 12-h (CPSMP) intervention group, or the 3-month wait-list control group. Self-report measures of pain-related and other quality of life variables as well as two hypothesized mediating variables were collected pre-treatment and 3 months later by assessors blind to group allocation. One hundred and two subjects completed the study. Results of intention-to-treat analysis indicated that the treatment group made significant short-term improvements in pain, dependency, vitality, aspects of role functioning, life satisfaction and in self-efficacy and resourcefulness as compared to the wait-list control group. Because it has a standard protocol, this intervention has the potential to be reliably delivered at low cost in varied urban and rural community settings and hence be more widely accessible to a greater number of people suffering from chronic pain than is currently the case with more specialized pain clinic services. Based on the results of this study, further research evaluating the long-term impact and potential cost savings to the individual and to the health care system is warranted.
Subject(s)
Pain/nursing , Pain/psychology , Patient Education as Topic , Self Care , Activities of Daily Living , Adult , Cognition , Community Health Nursing , Dependency, Psychological , Disability Evaluation , Female , Humans , Male , Middle Aged , Patient Satisfaction , Quality of Life , Severity of Illness Index , Treatment OutcomeABSTRACT
The purpose of this cross-sectional study was to examine the impact of the perceived quality of the parental relationship and family status on coping strategies, received support, and well-being in adolescents from separated or divorced and married parents. Two hundred forty-four matched adolescents from separated/divorced and married households were drawn from an initial sample of 1,044 students who were tested at five colleges and three high schools of a large metropolitan and rural area. Regression analyses supported the hypothesis that a perceived poor parental relationship, and not family status, was associated with low life satisfaction and sense of future, and high anxiety in adolescents of divorced and married households. Hierarchical regression techniques revealed that coping strategies and received support did not mediate the association between a perceived poor parental relationship and low levels of well-being in adolescents from divorced and married households. The findings underscore the importance of intervening with adolescents within the context of their family relationships.
Subject(s)
Divorce/psychology , Marriage/psychology , Psychology, Adolescent , Adaptation, Psychological , Adolescent , Adult , Case-Control Studies , Cross-Sectional Studies , Female , Humans , Interpersonal Relations , Male , Parents/psychology , Personal Satisfaction , Quebec , Social SupportABSTRACT
This descriptive multiple case study examined elderly home-care clients' perceptions of caring behaviours of the nurse within the context of the nursing relationship. Five clients were nursed over a 2-5 month period, during which time data were collected. Client perceptions of nurse caring behaviours were collected through one semi-structured interview at the termination of the nursing relationship. Results from this study support the perception of nurse attributes as caring, consistent with previous research. Moreover, the results suggest that these nurse attributes form the basis of caring in nursing interventions. A model of caring is proposed. Implications for nursing practice and future research are addressed.
Subject(s)
Aged/psychology , Nursing Care , Perception , Activities of Daily Living , Clinical Competence , Community Health Nursing , Female , Home Care Services , Humans , Male , Mental Health , Nurse-Patient Relations , Nursing Evaluation ResearchABSTRACT
The concept of social support has been the focus of growing multidisciplinary interest over the past two decades. Nurses are interested in the role that social support plays in promoting mental health. As empirical research on social support has been addressed with more scientific rigor, many conceptual and measurement issues have emerged. The purpose of this paper is to review the predominant conceptual and measurement issues in the study of social support in mental health nursing. Lack of consensus on conceptual clarity and weakness of measurement of the concept of social support are discussed in relation to the two bodies of literature. Directions for the development of nursing knowledge and methodologic approaches for future nursing research on social support and mental health are proposed.
Subject(s)
Mental Health , Nursing Research/methods , Nursing Theory , Psychiatric Nursing , Social Support , Health Promotion , HumansABSTRACT
OBJECTIVE: This study was conducted to determine whether a specialized form of nursing could help prevent or reduce psychosocial maladjustment among children, aged 4 to 16 years, with chronic physical disorders. In contrast to other studies, nurses were chosen to provide the intervention based on their central role in health care and the appropriateness of their training for this task. METHODOLOGY: A clinical trial was conducted in which 332 children and their families were randomly assigned either to receive this specialized nursing for a 1-year period, or to remain in the control condition. The children were all active outpatients in nine clinics at the Montreal Children's Hospital. Three measures of psychosocial functioning administered before and after the intervention were the basis for assessing its efficacy. The measures included the behavior problems profile of the Achenbach Child Behavior Checklist, the Personal Adjustment and Role Skills, completed by the parents, and two versions of the Self-Perception Profile (Harter) for children aged 4 to 7 years and 8 to 16 years. RESULTS: Differences between groups were examined both categorically and quantitatively. In the former, the percent of children with clinical scores (those above or below a cut-off indicative of maladjustment) at baseline and postintervention were compared. In the latter, the mean scores at the end of the trial were analyzed using analysis of covariance with the baseline scores as covariates. Statistically significant positive differences were found in the domain of anxiety/depression on the Personal Adjustment and Role Skills, and in the areas of scholastic competence, behavior, and global self-worth on the Harter. CONCLUSION: The results indicate that this intervention helps children with chronic disorders by preventing or reducing maladjustment. Most university-prepared nurses already have the basic skills required to achieve these results; only a modest investment in reorientation may be needed. Thus, other pediatric centers should be able to replicate these findings and thereby take a major step toward improving the lives of children with chronic disorders.
Subject(s)
Adjustment Disorders/nursing , Chronic Disease/nursing , Adjustment Disorders/etiology , Adjustment Disorders/prevention & control , Adolescent , Child , Child Behavior Disorders/etiology , Child Behavior Disorders/nursing , Child Behavior Disorders/prevention & control , Child, Preschool , Chronic Disease/psychology , Female , Humans , Male , Psychology, Adolescent , Psychology, Child , Self ConceptSubject(s)
Adaptation, Psychological , Health Status , Marriage/psychology , Social Support , Aged , Female , Geriatric Nursing , Humans , Male , Models, NursingABSTRACT
This article describes the salient features of the McGill model of nursing, (ie, health, family, collaboration, and learning), within the health, person, environment, and nursing paradigm. According to the model, the central goal of nursing is to maintain, strengthen, and develop the patient's health by actively engaging him or her in a learning process. Because health is a learned phenomenon and the family is considered the primary socializer in this learning, the family is the focus of nursing. The nurse strives to structure a learning environment that enables the patient to participate as fully as possible. The nurse and patient together set goals and, building on the patient's strengths and resources, devise means of achieving them.
Subject(s)
Models, Theoretical , Nursing Theory , Canada , Environment , Family , Health , Humans , LearningABSTRACT
This report is part of a larger study mounted for purposes of investigating the effects on a family of chronic pain in one of its adult members. Data concerning the spouses' understanding of their mate's pain along with the spouses' perception of the impact of this problem on their own health are presented. The factors of uncertainty and helplessness were found to be central to the distress experienced by the spouses in this study. The finding that the experience of living with chronic pain extends beyond the individual sufferer to encompass the family as a whole would suggest that health professionals must incorporate the family into the process of learning the meaning and management of chronic pain.
