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Biomedical subjects

A G Gift

Publications and source records attributed to A G Gift.

At least 19 recordsLinked to original sources
PubMed1991

Utilizing research assistants and maintaining research integrity.

The appropriate use and supervision of research assistants is essential to the success of a research study and the avoidance of academic misconduct. The focus of this article is to provide guidelines for the new principal investigator regarding hiring, contracting, orienting, monitoring, and evaluating research assistants. Particular attention is given to techniques that will avoid academic misconduct resulting from research assistants being uninformed or unsupervised.

Biomedical Research↗
PubMed1991

Sensations during chest tube removal.

Nurses prepare patients for chest tube removal, yet little has been written to indicate the sensations to be expected during this routine procedure. The sensations reported by patients and factors that could influence those sensations were examined in this study. The sample consisted of 36 patients after thoracic surgery (24 men and 12 women), all of whom were scheduled to have either a mediastinal or a pleural tube removed. They reported their sensations and the intensity of those sensations (using a 100 mm visual analog scale) within 15 minutes after tube removal. The most frequently reported sensation during chest tube removal was burning, followed by pain and pulling with mean intensities of 64, 62, and 45, respectively. Subjects reported having few sensations after the tube was removed with only five reporting soreness in the chest. The sensations and intensities did not differ for those who did and did not receive analgesia or for those having a pleural tube versus a mediastinal tube removed. The sensations were similar for the old and young subjects with younger subjects reporting higher intensities. Women reported pain more frequently than men, but the intensities of the sensations reported by men and women were not significantly different. The sensations reported during chest tube removal differ from those described in the literature and can be used to prepare patients more appropriately for chest tube removal.

Analgesia↗
PubMed1990

Utilization pattern of clinical nurse specialists in the Baltimore-Washington area.

In the present cost containment environment, hospitals often change their employment patterns. Nurses in advanced practice roles are particularly vulnerable to reassignment. In order to determine if the employment of Clinical Nurse Specialists (CNSs) in the Baltimore-Washington area had decreased and to determine what specialty areas employed the most CNSs, a survey of all area hospitals was conducted. The nursing departments of all 88 hospitals were contacted by phone with 40 of them (45%) agreeing to provide data. Seventeen institutions reported employing a total of 119 CNSs. Of these, only 12 required a Master's degree for nurses to hold that position. As expected, larger institutions employed more CNSs. This role appears to be stable, with only two institutions having eliminated CNS positions recently and five reporting plans to add such positions in the near future. Most CNSs reported either directly or indirectly to the Director of Nursing. Those in positions funded by another source reported to personnel in the funding department or agency. Almost all CNSs had clinical titles, and Psychiatric, Oncology, Medical and/or Surgical, Pediatrics or Critical Care were the most prevalent specialties mentioned. The CNS role is a viable role in the Baltimore-Washington area even in this time of cost containment. Most CNSs are identified with their area of clinical specialization.

Baltimore↗
PubMed1990

Dyspnea.

A multidimensional model of dyspnea that includes sensation, perception, distress, response, and reporting components is presented. Assessment tools currently available are evaluated as are recent research findings for pharmacologic, oxygen, physical, and psychologic treatments. This article concludes by suggesting a role for the nurse in dyspnea amelioration.

Dyspnea↗
PubMed1990

Psychophysiologic aspects of dyspnea in chronic obstructive pulmonary disease: a pilot study.

The level of dyspnea reported by the patient with chronic obstructive pulmonary disease is related to both the physiologic and psychologic state of the person at the time. The purpose of this pilot study was to explore, from a psychophysiologic perspective, the differences in anxiety, depression, and somatization during times of high and low levels of dyspnea. Six male subjects with chronic obstructive pulmonary disease, with a mean age of 64 years and a mean forced expiratory volume in 1 second that was 44% of predicted, completed the study. They were assessed for clinical signs and their level of dyspnea indicated on a vertical visual analogue scale, after which they completed the Spielberger State Anxiety Inventory and the Brief Symptom Inventory. Arterial blood was then drawn for blood gas analysis and determination of cortisol level. All measures were repeated twice, once when the subject reported a high level of dyspnea and once when he reported a low level. Analysis of the data by use of t tests for paired groups indicated that during times of high dyspnea levels subjects had greater anxiety, accessory muscle use, cortisol level, and PCO2 level. Subjects receiving oral prednisone had high depression levels that increased during times of severe dyspnea. Somatization, PO2, respiratory rate, depth of respiration, and other clinical signs did not change with dyspnea level. These results indicate that dyspnea is accompanied by both psychologic and physiologic changes that can be targeted to assist in alleviating this distressing symptom.

Aged↗
PubMed1989

Depression, somatization and steroid use in chronic obstructive pulmonary disease.

Steroid therapy has become part of the adjunctive treatment for COPD patients in some settings. Emotional changes have been reported in some patients while on these medications, but whether these changes are associated with the pathophysiological state or a side effect of the medication is not known. In this study self-reports of depression and somatic complaints were compared between two groups of COPD patients, 20 not receiving steroids and 20 receiving steroids. Both groups demonstrated comparable levels of disease and somatic complaints. Mean FEV1 value for those not receiving steroids was 34% of predicted while the mean for those receiving steroids was 30% of predicted. Depression was found to be significantly higher (t = 11.21, df = 38, p less than 0.01) in the group receiving steroids when compared to those not receiving steroids using a Student's t test. The higher degree of depression among steroid treated COPD patients has implications for clinical practice. The emotional status of this group of patients needs to be monitored and interventions initiated when necessary.

Aged↗
PubMed1989

Clinical research with patients in crisis: pitfalls and solutions.

Clinical research involving patients in crisis may be difficult to conduct because of the psychophysiological changes in the patient and the hectic environment of the health care setting. Clinical nurse specialists have the opportunity to expand nursing knowledge and contribute to nursing practice through initiation and/or participation in research with people in crisis. This article identifies potential pitfalls in conducting research with patients in crisis and suggests strategies for selecting a research design, data collection methodologies, and obtaining consent or approval.

Clinical Nursing Research↗
PubMed1988

Assessment of physiologic instruments.

Nursing researchers are advised to consider the reliability and validity of psychologic instruments used in research; however, evaluation of physiologic, or clinical, instruments is not always given the same attention. Reliability and validity issues related to physiologic measures will be discussed. Terms commonly used for the evaluation of physiologic instruments, such as "accuracy," "precision," and "sensitivity," will be explained, with parallels drawn to traditional measurement terms. Sources of potential measurement error, such as environment, user, subject, machine, and interpretation error, will be explained and specific examples given from cardiopulmonary nursing research.

Diagnostic Errors↗
PubMedDate not supplied

Validation of a vertical visual analogue scale as a measure of clinical dyspnea.

The purpose of this study was to validate a vertical visual analogue scale (VVAS) as a measure of clinical dyspnea. Concurrent validity was demonstrated by having asthmatics score their dyspnea intensity on both a VVAS and a horizontal visual analogue scale (HVAS), and then measuring their peak expiratory flow rate (PEFR). Correlation between the VVAS and HVAS was r = .97; between the VVAS and the PEFR, correlation was r = -.85, demonstrating the concurrent validity of the VVAS as a measure of dyspnea. Construct validity then was established, using the contrasted-groups approach with repeated measures. Both asthmatics and those with chronic obstructive lung disease (COPD) rated their dyspnea on the VVAS during times of severe and little airway obstruction. The dyspnea ratings at times of severe versus low obstruction were found to be different for both the asthmatic and COPD subjects. The VVAS was shown to have both concurrent and construct validity as a measure of dyspnea.

Asthma↗
PubMedDate not supplied

The effects of a program of systematic movement on COPD patients.

The intent of the study described in this article was to determine (a) if patients with chronic obstructive pulmonary disease (COPD) who regularly participate in less vigorous exercise programs, such as the program of systematic movement sponsored by the American Lung Association, differ from those who do not participate; and (b) whether these differences, if they exist, persist over time. Two convenience samples of COPD patients--those who practice systematic movement by participating in a pulmonary exercise program (PEP) and those who do not--were obtained through the American Lung Association of Maryland. Demographic information and health history were obtained from the participants and their physicians. They all completed the vertical visual analogue dyspnea scale (VADS) and the Beck Depression Inventory (BDI) on two occasions 8 weeks apart and described the strategies they used in dealing with their illness. Differences were found between the groups on the BDI and VADS at both measurement times. Those who participated in the program had lower depression (5.9 versus 17.75) and lower dyspnea (58.9 versus 78.8). These findings persisted 8 weeks later, with exercisers having depression levels of 5.5 versus 19 for the nonexercisers and dyspnea levels of 55.2 versus 79.4 for the nonexercisers. Exercisers used fewer emotion-focused coping strategies than nonexercisers. These findings have implications for the rehabilitation of COPD patients.

Aged↗
PubMedDate not supplied

Clinical measurement of dyspnea.

How often have you had a patient turn to you in distress, complaining of shortness of breath and wanting you to provide relief? This situation is often as distressing for the nurse as it is for the patient because there are few recommended nursing interventions designed to assist such patients. The author presents a nursing assessment tool for the dyspneic individual, which can be used to document the effectiveness of interventions for these patients.

Dyspnea↗
PubMedDate not supplied

Dyspnea: a case for nursing diagnosis status.

Dyspnea, the unpleasant subjective sensation of difficult breathing, is one of the most common symptoms experienced by patients with pulmonary and cardiac disorders. This article reviews the research concerning dyspnea and proposes it for consideration as a nursing diagnosis. The etiologies are categorized according to the neurosensory, neurochemical, cognitive, and affective mechanisms. The defining characteristics include the subjective words describing dyspnea, such as shortness of breath, suffocation, and tightness. The most supported objective sign of dyspnea in the literature is an increased use of accessory muscles of respiration. Nursing interventions for dyspnea relief are geared toward reducing the afferent activity from receptors in the respiratory muscles and dealing with the affective component of dyspnea. These interventions include pacing activities, breathing techniques, and inducing the relaxation response. Because most research for interventions to reduce dyspnea have focused on patients with obstructive lung disorders who have chronic dyspnea, recommendations for further research include using acutely ill patients and those with a variety of medical conditions.

Dyspnea↗