Multimodal chronic pain rehabilitation program: its effect on immune function, depression, and health behaviors.

This pilot study examined the effects of a multimodal pain rehabilitation program on the immune function, self-reported pain, depression levels, and health behaviors of patients with chronic back pain. It also estimated the relationships between self-reported pain levels, immune function, depression, and health behaviors. Data were collected at week 1 (baseline) and at week 4 (last week of treatment program) on a convenience sample of 23 patients. In general, the patients' mean T lymphocyte proliferation levels showed a decline from baseline to week 4, while natural killer cell activity showed a slight increase in cell lysis. None of the findings were statistically significant. Failure to detect significant differences may be attributed to a small effect size due to the relatively small sample size. The depression levels dropped significantly during the treatment program (p = .001). Reported levels of pain and health behaviors did not significantly change. More research is needed to determine treatment effects on immune function as well as relationships between pain levels, immune function, depression, and health behaviors in this patient population.

Broken past, fragile future: personal stories of high-risk adolescent mothers.

PURPOSE: To uncover what adolescent mothers view as their childhood struggles, their transition to the role of motherhood following a childhood of abuse/neglect, and their important relationships after they became parents. DESIGN: Qualitative, phenomenological. SETTING: Community-based parenting program for first-time mothers at risk for abusing or neglecting their children. PARTICIPANTS: Seven first-time mothers, ages 13 to 20, who reported they had been abused and/or neglected as children. All had healthy newborns. RESULTS: Five themes emerged from the data: impoverished past, disintegration of relationships, emotional distance, problem fixing, and reconnecting. Participants described a process of using the experience of pregnancy and parenting as a mechanism for growth. Becoming a parent provided an opportunity to receive support from family members and to build more positive relationships. They viewed the experience as a second chance for a successful and fulfilling life.

Effects of a multimodal pain rehabilitation program: a pilot study.

The purpose of this pilot study was to examine the effects of a multimodal pain rehabilitation program on pain perceptions, opioid usage, activity, down time, sleep, and role function status of 23 chronic pain patients. Data were collected at the start of the program, at the program's completion, and again during a follow-up period (3-11 months afterwards). At the end of the program, patients reported a significant reduction in pain levels, opioid usage, and hours of disturbed sleep. During the follow-up period, patients continued to report significant improvements in activity and role functions as well as significant reductions in opioid usage, sleep disturbance, and down time. These findings provided encouraging preliminary evidence that multimodal pain rehabilitation programs for chronic pain patients may be effective in pain management and functional restoration.

The Parent-Baby Venture Program: prevention of child abuse.

TOPIC: The overwhelming obstacles adolescents face to successful achievement of the maternal role. PURPOSE: To describe an innovative, community-based program to support high risk adolescents during the early postpartum period. SOURCE: A review of the literature related to programs designed to promote maternal-role attainment and prevent child abuse/neglect. CONCLUSION: Interviews with participants indicate a positive response to the intervention but regression to maladaptive behavior in some following termination.

Effects of a community health nursing parent-baby (ad)venture program on depression and other selected maternal-child health outcomes.

This pilot study measured the effects of a community health nursing parent-baby (ad)venture program for first time mothers who were at risk for child abuse or neglect and depression. A quasi-experimental pretest-posttest design was used. Fifteen high-risk mothers in the program were compared with 15 similar mothers who received home visits from the community health nursing staff. Measures of depression, health behaviors, self-esteem, state anxiety, and maternal-infant adaptation were measured in both groups when the mothers were 4 and 16 weeks postpartum. After controlling for pretest differences, the findings showed that program mothers reported significantly higher levels of self-esteem at the three-month period than those receiving home visits (P < 0.013). In addition, over time these mothers had significantly decreased levels of depression (P < 0.009) and significantly improved their health habits (P < 0.003). Those who received home visits showed no significant changes over time.

Relaxation with guided imagery: effects on employees' psychological distress and health seeking behaviors.

1. Relaxation with guided imagery (RGI) has been successfully used for controlling acute pain, emotional distress, anxiety, and depression in a chronically ill population. Only a few studies have examined RGI as a therapeutic modality for reducing psychological distress and facilitating improvement in health behaviors. 2. The purpose of this study was to examine the effects of RGI on decreasing psychological distress and improving health seeking behaviors with a working population. 3. The practice of RGI did not significantly reduce employees' psychological distress or improve their health seeking behaviors. However, anecdotal data suggest that RGI may be useful for some individuals. 4. Because RGI is a simple, inexpensive, and non-invasive technique that most employees can do on their own, additional research efforts are needed to support its effectiveness.

Evaluating a staff development physical assessment program.

This program evaluation assessed whether nursing staff who took a mandatory physical assessment course were using the information in their daily practice. A questionnaire designed to assess clinical usage of 17 physical assessment skills was sent to the nurses who completed the first four classes of the assessment course. The results showed that the majority of the nurses used only nine of the 17 skills on a daily basis. Skills used most frequently were mental status and skin system assessments. The skills reported as least used were assessments for extraocular movements, cranial nerves, and jugular vein distention. These results imply that nurses may be applying only those skills required by the patient population on their particular unit. Staff development educators need to reassess physical assessment course content and tailor the courses to teach the skills required for specialty patient populations.