The effectiveness of a self-care management interactive multimedia module.

PURPOSE/OBJECTIVES: To develop and test an interactive multimedia module prototype designed to accommodate adults with limited literacy and without computer skills. DESIGN: Experimental, randomized, controlled, pretest, post-test. SETTING: Cancer treatment centers in California, Louisiana (pilot). New Hampshire, Pennsylvania, and Texas. SAMPLE: Outpatients who were at least 18 years old with a minimum fifth-grade reading level; 86 experimental treatment, 88 control. METHODS: Experimental treatment involved use of the interactive multimedia module; the control group received customary Instruction. FINDINGS: As compared to the control group, subjects in the experimental group had significant improvement (p = 0.0001; 257% gain) in self-care ability regardless of age, sex race, education, geographic location, reading ability, computer experience, or preferred learning style; a 6.515% increase in fatigue content covered and 16.775% Increase in instructional duration; and significantly greater benefit from sleep-related activities and a consistent, positive pattern of self-care behavior. CONCLUSIONS: The program is instructionally effective, appropriate for a wide and geographically diverse audience, and feasible for use in the ambulatory setting. IMPLICATIONS FOR NURSING PRACTICE: The interactive multimedia module is an effective, self-directed resource for individualized patient fatigue education.

[Biocenosis of the vagina and infection with Chlamydia trachomatis]. / Biocenoza pochwy a zakazenie Chlamydia trachomatis.

The authors have examined 379 women for infection by Chlamydia trachomatis, performing vaginal smears and routine bacterial cultures. C. trachomatis was discovered in 33.2% of the women, most frequently accompanied by erosion of the collum, cervicitis and CIN-Ca. Women with C. trachomatis had the following levels of vaginal purity: 1-44.4%, 2-23.0%, 3 and 4-29.4%, 3.2% -leukocytes only. Leukocytes were present in significantly more women with level 1 of vaginal purity than in the control group. Additional infections (Gardnerella vaginalis, Streptococcus agalactiae, Candida albicans, Escherichia coli and Trichomonas vaginalis) were found in only a small percentage of women with C. trachomatis, just as in controls. The presence of leukocytes or level 1 of vaginal hygiene with leukocytes may favour C. trachomatis, just as in controls. The presence of leukocytes or level 1 of vaginal hygiene with leukocytes may favour C. trachomatis infection, therefore these cases should be subjected to a more thorough examination.

[Lichen sclerosus in girls--risk group for development of vulvar neoplasms in women]. / Lichen sclerosus u dziewczat--grupa ryzyka rozwoju raka sromu u kobiet?

Lichen sclerosus is one of the vulvar dystrophy, which is rare at children and young women. 20 girls, aged 3 to 14 years, with clinical and histopathological diagnosis--lichen sclerosus without dysplastic lesions--were under the control of The Gynecological Outpatient Clinic of Children and Girls in Szczecin. They were treated with estrogens (estriol with vitamin A--ointment) and vitamin A rich diet. Anti-inflammatory treatment was employed if necessary. After long-term treatment at 8 girls the total recovery was obtained, at 2, clinical symptoms decreased. Other girls are under clinical observation as before. The girls with lichen sclerosus are a risk group of vulvar carcinoma development in mature age.