ABSTRACT
The goal of this study was to evaluate a community-based psychoeducational-nursing intervention designed to teach home caregivers to manage behavioral problems of persons with Alzheimer's disease and related dementias (ADRD) using the Progressively Lowered Stress Threshold (PLST) model, and to compare this intervention with routine information and referrals for case management, community-based services, and support groups. Previous caregiver studies have overwhelmingly pointed to the adverse effects of caregiving on the caregivers' physical and mental health, and high prevalence rates of depression among caregivers of persons with ADRD have consistently been reported. Therefore, a primary aim was to evaluate the impact of the intervention on caregivers' affective responses, especially depression. Data from both the Profile of Moods States and the Geriatric Depression Rating Scale support the effectiveness of this intervention in decreasing depression among caregivers who received the experimental training. Additional analysis of factors associated with caregiver depression are also reported. The pivotal role of psychiatric nurses in the assessment and treatment of depression among caregivers of persons with ADRD is discussed.
Subject(s)
Caregivers/education , Caregivers/psychology , Community Health Nursing/methods , Dementia/nursing , Depression/nursing , Depression/prevention & control , Family/psychology , Adaptation, Psychological , Aged , Depression/etiology , Depression/psychology , Female , Humans , Longitudinal Studies , Male , Middle Aged , Nursing Evaluation Research , Psychiatric NursingSubject(s)
Home Care Services/organization & administration , Public Health Nursing , Aged , Female , Humans , Male , Middle Aged , Minnesota , Reimbursement MechanismsABSTRACT
Gonadotropins are released in a pulsatile fashion at a frequency of between 1 and 2 hours in the follicular phase of the menstrual cycle. Human menopausal gonadotropins are usually administered intramuscularly. We evaluated the gonadal response to intravenous human menopausal gonadotropins administered in a pulsatile fashion over nine treatment cycles in three anovulatory infertile women. Human menopausal gonadotropin pulses in doses up to 12 IU follicle-stimulating hormone at frequencies between 2 to 3 hours over 3 to 17 days resulted in ovulation in five cycles with one pregnancy being conceived. In the ovulatory cycles (5,000 to 10,000 IU of human chorionic gonadotropin was used to induce ovulation), the 17 beta-plasma estradiol level was 961 +/- 128 versus 326 +/- 95 pg/ml (mean +/- SEM) in the anovulatory cycles (p = 0.015). The dose of human menopausal gonadotropins (in ampules of Pergonal, 75 IU of follicle-stimulating hormone and 75 IU of luteinizing hormone) in the intravenous cycles needed to induce ovulation was 12.3 +/- 1.4 versus 20.4 +/- 0.9 for intramuscular cycles (n = 80 in 23 women, p = 0.008). Treatment was well tolerated and without complications. We are continuing to explore the use of this apparently more efficient mode of administering human menopausal gonadotropins to anovulatory patients resistant to other techniques of ovulation induction therapy.
Subject(s)
Infertility, Female/therapy , Menotropins/administration & dosage , Ovulation Induction/methods , Adult , Anovulation/drug therapy , Chorionic Gonadotropin/administration & dosage , Clomiphene/therapeutic use , Drug Resistance , Female , Follicle Stimulating Hormone/administration & dosage , Humans , Injections, Intravenous/methods , Pituitary Hormone-Releasing Hormones/therapeutic use , PregnancyABSTRACT
An efficient and inexpensive pump has been developed for the circulation of gaseous mixtures in a closed system. A continuous unidirectional flow of gas at rates of 0-40 l min(-1) was produced over an operating range of 10(-5)-10(-3) Torr.