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Biomedical subjects

A Foote

Publications and source records attributed to A Foote.

10 recordsLinked to original sources
PubMed1992

Neuman systems model used as a guide for the nursing care of an 8-year-old child with leukemia.

The Neuman Systems Model (NSM) provides a framework for holistic pediatric oncology nursing practice. In this article, an overview of NSM is given. This model is applied to an 8-year-old child with leukemia for the comprehensive assessment, planning, and evaluation of nursing care. A comprehensive list of nursing diagnoses is categorized by primary and secondary prevention.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

The core technology of work-site wellness.

Work-site wellness programming his evolved through four stages of development. This article proposes a core technology of work-site wellness programs comprised of 10 dimensions that organize and systematize the range of activities undertaken by such programs. These 10 dimensions address the following tasks: (1) establishing program policy, (2) assessing the health status of the work force, (3) linking the work site with service providers, (4) linking individual employees with services appropriate to their needs, (5) providing options for behavior change strategies and interventions, (6) engaging employees in these various interventions, (7) organizing work-sitewide activities to support health improvement, (8) reviewing and altering organizational policies to make the work environment more supportive of health, (9) routinely evaluating program process and changes in health risks, and (10) periodically assessing longer-term program results. Two future dimensions are described that require further evidence of impact. Arguments and evidence in support of each dimension are provided, including discussion on how activities within each dimension work together to produce maximum effectiveness, and how various dimensions relate to each other to make an effective overall program.

Comprehensive Health Care↗
PubMed1991

The benefit to cost ratio of work-site blood pressure control programs.

Reduction in the cost of health care claims among hypertensive employees was examined over a 4-year period after exposure to a 3-year blood pressure control program, to see whether work-site monitoring and counseling produced a subsequent benefit. Hypertensive employees at three experimental sites (N = 183 to 367 subjects) were compared with subjects at a control site (N = 169) who had received no postscreening follow-up or monitoring, and with matched normotensive employees. The cost of subsequent health care claims for hypertensive employees at the experimental sites was lower than claims for those at the control site, but there was no significant difference across the sites in claims for normotensive employees. After adjusting to a standard 1982 dollar, the data showed from $1.89 to $2.72 in reduced health care claims per dollar spent operating the hypertension control program.

Blood Pressure↗
PubMed1991

Hope, social support and self-esteem of patients with spinal cord injuries.

A descriptive study was conducted to determine if a relationship among the variables of hope, social support and self-esteem existed in persons with spinal cord injuries. A demographic data sheet and three instruments were used: Miller Hope Scale (MHS), Personal Resource Questionnaire Part II (PRQ) and Rosenberg Self-Esteem Scale (RSES). Of the 83 inpatients and outpatients who agreed to participate, 77 sets of questionnaires were usable. Ages of subjects ranged from 18-73 (mean 34.8) years and levels of injury ranged from C4-L3. The mean scores on the tools were: MHS-153.51 (40-200 possible range), PRQ-137.42 (25-175 possible range) and RSES-29.59 (10-40 possible range). There was a statistically significant relationship between hope and social support, hope and self-esteem and social support and self-esteem. By multiple regression analysis, the best predictors of hope in the subjects were self-esteem, social support and education.

Adult↗
PubMed1991

Effects of EAP follow-up on prevention of relapse among substance abuse clients.

Clients entering an employee assistance program (EAP) of a large manufacturing plant in 1985 who were assessed as having an alcohol or drug abuse problem (N = 325) were randomized into an experimental "special follow-up" group and a control "regular care" group. The regular care group received follow-up only as needed (following the usual practice of the EAP), while a follow-up counselor was hired to make routine contacts with the special follow-up group. Study intake continued through 1985, and follow-up continued through the end of 1986. Data collected on study subjects included EAP participation data, absenteeism, number of hospitalizations, health care claims paid and disability claims paid. The major study hypothesis was that EAP clients randomly allocated to special follow-up would show better results than regular care clients (i.e., would have fewer relapses, better job attendance and lower health benefit utilization during the follow-up year). The follow-up intervention was incompletely implemented due to a variety of organizational problems. Differences between the two groups on the six outcome measures were not statistically significant, although clients in the special follow-up group did show better results than clients in the regular care group on the three measures related to substance abuse. Differences on these three measures were marginally significant in regression analyses after controlling for the effects of number of follow-up visits, age, race and chronicity.

Adult↗
PubMed1991

The cost-effectiveness of work-site wellness programs for hypertension control, weight loss, and smoking cessation.

The cost-effectiveness of work-site wellness programs for reducing cardiovascular disease risks of employees was examined at three manufacturing plants. A fourth plant was used as a control site to estimate levels of risk reduction achieved from wellness screening and preexisting services, without further interventions. The cardiovascular disease risks included in the study were hypertension, obesity, and cigarette smoking. The annual direct cost per employee for postscreening interventions was $2.97 for site 1 (control site), $17.68 for site 2 (health education), $30.96 for site 3 (health education plus follow-up counseling), and $38.31 for site 4 (health education, follow-up counseling plus plant organization for health promotion). Of the three experimental sites, sites 3 and 4 were more effective and more cost-effective than was site 2, both in terms of engaging employees at risk of cardiovascular disease into treatment or program participation and of reducing their risks or preventing relapse. For engaging employees into treatment/program participation, sites 3 and 4 were nine to ten times more cost-effective than was site 2; for reducing risks/preventing relapse, sites 3 and 4 were five to six times more cost-effective than was site 2. At sites 3 and 4, the total direct cost per percent of risks reduced/relapse prevented was less than one dollar ($.67 and $.74, respectively) per employee per year. Program costs may vary considerably across companies because of differences in salary structures and overhead costs. These are held constant in this report for comparison across program models.

Adult↗
PubMed1990

Maintenance of blood pressure treatment and control after discontinuation of work site follow-up.

Participants in a 3-year study of hypertension control at four work sites were rescreened 4 years after discontinuation of the study protocols. At the end of the 3-year study period, employees at the study sites that provided routine follow-up monitoring had shown significantly better levels of blood pressure control than at initial screening and significantly better levels than employees at the site that did not provide follow-up monitoring. But 4 years after discontinuation of the follow-up services this was no longer true. The level of blood pressure control at the experimental sites was no better than at the control site, and the level of control at all study sites was no better than would have been predicted for a population that had aged by 7 years. Some 17.6% of the participants were found to be in remission (with normal blood pressure readings, not under treatment), but the data suggested that they were at risk of future blood pressure elevations, warranting continued monitoring. The major predictor of continuation in treatment was frequency of blood pressure monitoring, but frequency of monitoring was not associated with maintenance of good control. It is concluded that follow-up monitoring programs at the work site should be treated as permanent services, not short-term programs.

Clinical Protocols↗
PubMed1990

Worksite follow-up and engagement strategies for initiating health risk behavior changes.

Information is presented from a multiplant study of interventions to improve cardiovascular health among employees. Risk factors targeted were high blood pressure, obesity, and cigarette smoking. The study utilized on-site wellness counselors who periodically contacted all employees identified through screening as having one or more of the three risks. Use of a structured protocol for client outreach resulted in the large majority of clients being seen in follow-up during the three-year intervention period. Drawing from caseload experience and from various theoretical perspectives, seven engagement strategies were used to help guide at-risk clients toward successful behavior changes to reduce health risks. Results showed that of the three at-risk groups, clients with high blood pressure were most likely to be seen in follow-up, and most likely to begin a risk reduction program. For the overweight and smokers, clients seen three or more times were more likely to begin a weight-loss/smoking cessation program than clients seen less often. Frequency of follow-up showed a positive relationship with risk reduction for all three risks, in samples of employees rescreened at the end of the intervention period, but the relationship was not statistically significant for smoking cessation.

Cardiovascular Diseases↗
PubMed1979

A hospital-based screening, referral, and follow-up program for high blood pressure.

A hypertension program staffed largely by volunteer nurses in a hospital outpatient department is described. A three-year evaluation shows 19% of 4,282 clients screened as having high readings, 86% of those referred saw a physician for high blood pressure, 92% of those who saw a physician began treatment for high blood pressure and 50% of those under treatment were showing successful control or progress toward successful control.

Evaluation Studies as Topic↗