Evaluating staff use of crisis prevention intervention techniques: a pilot study.

The purpose of this pilot study was to evaluate staff use of crisis prevention intervention (CPI) techniques in averting crisis episodes at the various levels (anxiety, defensive, and acting out) of a crisis (resulting in reduction of seclusion and restraint episodes and patient/staff injuries). A descriptive correlational research design was used. Data were collected by nurse observers trained in CPI techniques through observation of patient incidents and staff interventions. A 51-item CPI instrument based on the CPI training program techniques was developed and used for data collection. Data were analyzed using descriptive statistics, Pearson correlation, t tests, ANOVA, and the Scheffe test. One hundred forty-six observations of patient incidents were completed on both day and evening shifts. The results of the study indicate that staff use of CPI training program techniques was effective in resolving crises in 84.2% of the episodes observed and over a wide variety of diagnostic and functional levels.

Hmong women and postpartum depression.

Evidence of postpartum depression in Western culture has been widely documented in the literature. The conclusion reached by many researchers is that women are vulnerable to depression following childbirth to some extent. It has been suggested that postpartum depression is a culture-bound syndrome that develops because of lack of supportive rites and rituals surrounding childbirth. The present study was undertaken to explore postpartum depression in Hmong women living in the U.S. and the influence of cultural practices on postpartum depression. The results indicate that cultural beliefs and practices help the Hmong women adjust to the postpartum period. Whatever symptoms of depression they reported were related to living in a different culture and different environment, and using a language to which they were not accustomed.

Depression: dealing with the darkness.

TOPIC: A client's personal experience of depression presented in her own words. SOURCE: Case study. PURPOSE: To assist nurses to understand, accept, and reassure depressed clients and "offer themselves" in a caring and continuing relationship. CONCLUSION: Understanding depression allows nurses to respond in a way that is therapeutic.

Hmong women in Wisconsin: what are their concerns in pregnancy and childbirth?

Childbirth in different cultures is treated as a traumatic life crisis and a time of vulnerability for the mother and infant. This qualitative descriptive study explored specific concerns related to pregnancy and childbirth in 52 Hmong women living in central and northeastern Wisconsin. Women were questioned using a semistructured interview about 4.6 months after childbirth. They described concerns related to breastfeeding, contraception, touch, communication with health caregivers, and procedures performed during childbirth. Women preferred bottle-feeding over breastfeeding. They reported difficulty practicing birth control because of cultural expectations of male and female roles, but were aware of the need for education about methods of contraception. Fear of miscarriage if they were touched by doctors and nurses resulted in delayed prenatal visits. The women believed that invasive procedures such as episiotomies and circumcisions are not natural, and they preferred natural tearing and healing. It is important for health caregivers to be culturally sensitive and understanding of Hmong practices and beliefs when touching and communicating with these women and when educating them about breastfeeding, contraception, and medical procedures during hospitalization.

Use of RN case management and costs and utilization of outpatient mental health services: a pilot study.

The majority of outcome studies on case management seem to have been studied on the chronically mentally ill patients. Little is known regarding the use of a case management approach with general psychiatric populations, which include non-chronically mentally ill patients in an outpatient setting. This study examined the effect of a registered nurse case management (RNCM) model on the delivery and cost of mental health services during an 18-month period for clients in an outpatient psychiatric setting. Sixty clients met the criteria for sample selection. The data indicated that the use of the RNCM model resulted in more nursing than psychiatric care. Despite more frequent visits to the RNCM and longer RNCM visits, RNCM services appeared cost effective and were related to decreased length of hospital stay. A subgroup of high-risk clients was identified, and a significantly greater use of services by this group was substantiated.

Hmong cultural practices and beliefs: the postpartum period.

The purpose of this study was to explore the cultural practices and beliefs of the Hmong in the postpartum period. Using the qualitative research method of in-depth interviewing, data were collected through semistructured interviews. A convenience sample of 52 childbearing Hmong women was interviewed with the help of Hmong interpreters. The interviews were audiotaped and transcribed for analysis. Data analysis revealed cultural practices and beliefs categories related to diet, rest period, appropriate clothing, breast feeding, and sex practices in the postpartum period. Implications for nursing include both cultural sensitivity and an understanding of such traditional practices, before suggesting or implementing any health-promotion activities.

PIP: In this exploratory descriptive study, the qualitative research method of in-depth interviewing was used. A convenience sample of 52 postpartum Hmong women from northeastern and north central Wisconsin were interviewed through semistructured interviews. They ranged in ages from 18 to 44 years, with a mean age of 27.3 years. All were married, and had 1-11 children. The women's length of stay in this country ranged from 1 month to 15 years, with a mean of 5.3 years. Seven of the women were primiparas. The majority (88%) were homemakers. 75% of the women did not speak English. Their educational levels ranged from either no education to English as a second language, or to more than 12 years of education (25%). All of the Hmong women stated that they followed their cultural beliefs and practices in taking care of themselves and their babies during the postpartum period. Diet usually consisted of warm chicken and rice, with no fluids, to prevent diarrhea and stomach cramps. The belief was that increased fat consumption would lead to constipation. Pork or beef was considered fatty stuff and would clog the blood. A general belief was that eating vegetables made one sick and would cause trouble with pregnancy. A rest period of one month seemed to be the norm after childbirth, during which she was confined in the home and got served by her in-laws. All of the Hmong women, except one, stated that they bottle fed rather than breast fed for the sake of convenience, because they were unable to produce milk. Many Hmong women stressed the importance of not having sex until after the rest period of one month. The Hmong women also discussed other ways to stay healthy during postpartum. They suggested taking adequate rest and not lift anything heavy or do household tasks. Nurses should observe Hmong traditional practices in any health promotion activities.

Pilot study results: the psychiatric RN case manager.

1. It is important to examine client and staff satisfaction with the RN case management (RNCM) model to enhance the quality of care in psychiatric settings. 2. Ninety-two percent of clients surveyed ranked the RNCM care as "excellent" or "above average." Clients valued most the humanistic role of the RNCM and repeatedly commented on the importance of the nurse being caring, genuine, and supportive. 3. RNCMs expressed high satisfaction with their role, which they described as collaborative with the psychiatrist, yet also professional and independent. Psychiatrists expressed a high degree of confidence that clients were receiving excellent care by competent nurse professionals.

Planning a peer review program.

The purpose of this study was to provide a basis for the planning and subsequent implementation of a peer review program, concomitant to exploring the perceptions of registered nurses regarding initiating a peer review program in a small midwestern hospital. The study findings indicated that registered nurses liked the peer review process, perceived peer review as helping their professional growth, and indicated a strong desire for education and in-service. Based on the study results, planning and recommendations for further implementation are discussed.

Sociocultural factors in depression in Asian Indian women.

Depression is a pervasive illness with a wide distribution and is reported to be statistically more prevalent among women. The present study was undertaken to seek an understanding of depression in a sample of Asian Indian women. The research questions were (a) What sociocultural factors do adult depressed Indian women report as influences in the depression, and (b) how do these reported factors influence their treatment-seeking behavior? The setting was Madurai, India. The purposive, convenience sample comprised 30 Tamil-speaking married or widowed Hindu women ranging in age from 26 to 65 who had been diagnosed with depression. Tape-recorded interviews were conducted. Content analysis was completed on the data. Results indicate that cultural dictation of female role and lack of continued financial and emotional support, predominantly from spouses and other family members, were influential factors in depression. These along with religion and philosophy often influenced the decision to seek health care.