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Biomedical subjects

A Helm

Publications and source records attributed to A Helm.

At least 19 recordsLinked to original sources
PubMed1996

Respiratory rehabilitation, exercise capacity and quality of life in chronic airways disease in old age.

Respiratory rehabilitation improves exercise capacity and quality of life in younger patients but is untried in the aged. We aimed to: (a) assess repeatability of the 6-minute walk test, factors affecting it and its relation to quality of life in elderly patients with chronic obstructive airways disease (COAD); (b) assess compliance of such patients with an intensive respiratory rehabilitation protocol; (c) pilot the assessment of the effect of respiratory rehabilitation on the 6-minute walk test in these patients. Seventeen subjects with stable, symptomatic COAD were recruited, 15 (six men), 70-89 (mean 76) years, completed the study. Mean (standard deviation) 1-second forced expiratory volume (FEV1) = 49 (5)% predicted. Six-minute walk tests were repeated single-blind, 2-10 days apart. Quality of life was measured using Guyatt respiratory questionnaire. Patients underwent 12 weeks incremental respiratory rehabilitation (x4/day step-ups, unweighed arm raises, inflating balloons). Baseline 6-minute walk was repeatable and was correlated with the log Guyatt dyspnoea score (r = 0.65, p = 0.006). In multiple regression neither age nor FEV1 predicted walk distance: body mass index, maximal expiratory mouth pressure; calorie intake. Mean (SEM) 6-minute walk distance after-rehabilitation was greater than baseline (p = 0.003). Elderly patients with COAD tolerate intensive respiratory rehabilitation and a controlled, blinded study is needed.

Aged↗
PubMed1986

Elder abuse.

Explore the source record for details and available documents.

Aged↗
PubMed1985

Truth telling, placebos, and deception: ethical and legal issues in practice.

The issue of truth-telling is very complex. There is variance among patients in the amount of information they want to be told and variance among professionals in the amount of information they want to tell. Truth is conditioned by our knowledge limits and understanding. Technological advances in health care have made this arena even more complex. Placebos have been viewed traditionally as a kind of benign deception. Few studies have looked at treatments and tests as placebos. There are many myths associated with placebos and placebo therapy. There are five primary theories for withholding the truth or promoting deception with patients. Ethical and legal principles generally support veracity and the concept of a duty to tell the truth. One of the remaining issues is whether the placebo effect can be achieved without deception.

Aerospace Medicine↗
PubMed1984

Ethical dilemmas and nursing.

Professional responsibilities, tradition, and personal conscience along with legal, philosophical, and religious convictions dictate nursing interventions. Inevitably, these factors embrace life-sustaining therapies; however, in view of complications, prognosis, pain and suffering, and their own views of quality of life, some patients express wishes inconsistent with life-sustaining measures. In other situations, the health care provider as well as the patient may view heroic efforts as more debilitating than resortative. Resolving the conflict while preserving the patient's best interests requires a confrontation with the status of "do-not resuscitate" policies within th e nurse's institution, informed consent, refusal, and competency as the necessary underpinnings for the development of an ethical and legal posture within the profession, with which to approach significant decisions regarding life-sustaining therapies. Literally every hour of every day nurses are immediately and directly involved with resolving ethical dilemmas based upon judgements and interpretations of oral or written orders, patient and family wishes, professional training, and an infinite number of other factors. When clear policies or orders are lacking, the nurse is left with the burden of making a life or death decision. It is imperative that professional nurses assess the administrative, legal, and ethical ramifications of their actions in terms of ethical codes of practice, patients' rights, institutional and personal liability, civil and criminal laws, and private conscience. An understanding of these issues, passive and active euthansia, state and national trends, and uniform legislation can assist in resolutions of the no-code dilemma. Nursing as a profession must strive to develop sound and consistent guidelines and rationale for the scope of practice in ethical dilemmas.

Conflict, Psychological↗
PubMed1978

The Christchurch Hospital diabetes education programme.

The Christchurch Hospital diabetes teaching programme is now well established and towards the end of 1977 the results of an evaluation programme should be available. Our aim is to give diabetics and their families the best possible education and to stress the importance of patient self-sufficiency. Patient feedback methods are used to encourage continuing education. The assessment of the value of the educational programme warrants considerable attention and suitable methods of evaluation are being attempted.

Diabetes Mellitus↗