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Biomedical subjects

A K Derdiarian

Publications and source records attributed to A K Derdiarian.

17 recordsLinked to original sources
PubMed1994

Monitoring transfusionist practices: a strategy for improving transfusion safety.

BACKGROUND: Data from New York State indicate that about 1 of every 33,000 red cell units transfused is ABO-incompatible with the recipient. National application of these data suggests that as many as 360 ABO-incompatible whole blood and red cell transfusions might occur annually in the United States. Phlebotomy and blood bank laboratory errors cause some of these ABO-incompatible transfusions, but the greatest number result either partially or solely from the failure of transfusionists to identify properly either a patient or the blood component a patient receives. STUDY DESIGN AND METHODS: A quality assessment/quality improvement (QA/QI), process is described that allowed for the direct oversight (monitoring) of transfusionists' practices and for the assessment of institutional policies for blood administration. RESULTS: At the beginning of the QA/QI process, monitoring of blood administration practices revealed that a variance from institutional blood administration policy occurred during 50 percent of blood and component transfusions. As a result of the QA/QI process, the percentage of transfusions with an associated variance from institutional policy dropped to nearly zero. CONCLUSION: The QA/QI process described in this report, or one similar to it, could improve transfusion safety and serve as a model for increased involvement by transfusion service medical directors in the oversight of transfusionists' practices.

Blood Transfusion, Autologous↗
PubMed1990

Comprehensive assessment of AIDS patients using the behavioural systems model for nursing practice instrument.

The major changes resulting from the AIDS diagnosis and illness were measured, described and classified in the Behavioural Systems Model's eight subsystems--achievement, affiliative, aggressiveness/protectiveness, dependence, ingestive, eliminative, restorative and sexual. Thirty male AIDS patients with Kaposi's Sarcoma were drawn as a convenience sample from a major medical centre's outpatient clinic. The subjects self-rated their perceived changes in the above eight major areas, using a 140-item instrument (DBSM) consisting of 24 categories of changes distributed in the above eight areas. Patients reported changes in all categories and described them in terms of direction, quality and relative importance. Ordinal ranks of changes existed among the eight major subsystems' frequency and importance of change scores, as shown by ANOVA and Tukey's studentized t-tests of rank.

Acquired Immunodeficiency Syndrome↗
PubMed1990

The relationships among the subsystems of Johnson's Behavioral System Model.

The major premise of the Johnson (1980) Behavioral System Model is that the eight subsystems (domains) are interactive, interdependent and integrated. Relationships among the subsystems were hypothesized, placing the Aggressive/Protective subsystem centrally as having direct and indirect relationships to the other seven subsystems. In the present study, the Behavioral System Model instrument generated two sets of scales that indicated changes as increase or decrease and positive or negative in the subsystem resulting from illness. Two causal models were tested, one for each set of scales, both supporting the hypotheses pertaining to the relationships between the Aggressive/Protective subsystem and the other subsystems. The findings warrant further investigation of these relationships and imply that changes in a domain resulting from illness cannot be well understood without understanding their relationship to changes in other domains.

Adolescent↗
PubMed1989

Effects of information on recently diagnosed cancer patients' and spouses' satisfaction with care.

The effects of an intervention consisting of information, referral, counseling, and follow-up care individualized to patient and spouse needs on satisfaction and coping were determined from data gathered from 30 recently diagnosed male cancer patients and their spouses. A control group of 30 recently diagnosed cancer patients and their spouses received routine information, referral, counseling, and follow-up care. All participants were assessed for their informational needs using the Informational Needs Assessment instrument, and all self-rated their satisfaction with information received using the Satisfaction (SAT) instrument. Couples in the experimental groups received formal individualized intervention as described earlier. Two weeks after the initial testing but before medical intervention, all participants again self-rated their satisfaction using the SAT instrument. The results of a repeated measures analysis of variance test indicated that the experimental groups gained more information and were more satisfied with that information when compared with their counterpart control groups.

Adaptation, Psychological↗
PubMedDate not supplied

Effects of using systematic assessment instruments on patient and nurse satisfaction with nursing care.

To determine the effects of using systematic assessment instruments on patient and nurse satisfaction with the nursing process, a single-group, pre- and postintervention quasi-experimental design was used in a three-phase study. In the pre- and postintervention control phases, nurses used a routine clinical assessment instrument to implement the nursing process; in the intervention phase they used the Derdiarian Behavioral System Model (DBSM) self-report and the DBSM-O (observational) instruments. The Comprehensiveness of Nursing Assessment and the System of Practice instruments were used to evaluate the comprehensiveness and quality of care respectively; the Patient-Satisfaction and Nurse-Satisfaction instruments were used to evaluate patient and nurse satisfaction with care. The findings showed that the increase in patient and nurse satisfaction was statistically significant when the DBSM and DBSM-O instruments were used.

Clinical Nursing Research↗
PubMedDate not supplied

Informational needs of recently diagnosed cancer patients.

Informational needs of 60 recently diagnosed cancer patients were assessed in relation to their disease, personal, family, and social concerns. The theoretical framework underlying the study was constructed from theories of coping, appraisal, information seeking, needs, and hierarchy of needs. Categories of analysis were derived from these theories and from findings of previous research. The Derdiarian Informational Needs Assessment was used to gather data. Patients' informational needs were described in relation to harms, threats, and resources and to their importance values associated with the major categories of disease, personal, family, and social concerns. Comparisons of informational needs and their importance values among patients stratified by person- or situation-related variables indicated few differences by gender, age, and stage of cancer. The findings imply that informational needs may be universal and warrant research on their relationship to these variables.

Adaptation, Psychological↗
PubMedDate not supplied

The D-L test of agreement: a stronger measure of interrater reliability.

This article examines the theoretical underpinnings and the procedures of the Derdiarian-Lewis (D-L) test of proportion of complete agreement to determine reliability among raters. The D-L test yielded data produced by three raters who rated an average of 253 units of verbal content for each of six patients. The test is supported as a stronger measure of interrater reliability than the conventionally used percent agreement method.

Humans↗
PubMedDate not supplied

An instrument for theory and research development using the behavioral systems model for nursing: the cancer patient. Part I.

The initial steps in theory development and testing are analysis, theoretical development, operational definition, and measurement of concepts. For nursing models to be useful in research, practice, and education, their concepts should be treated as such. This paper presents the first three of such steps using the Behavioral Systems Model for Nursing. The steps of measurement and verification will be presented in subsequent papers in Nursing Research.

Achievement↗
PubMedDate not supplied

An instrument for theory and research development using the behavioral systems model for nursing: the cancer patient. Part II.

The purpose of the Derdiarian Behavioral System Model (DBSM) instrument was to measure and describe, within the Johnson Behavioral System Model (JBSM) perspective, the perceived behavioral changes of the cancer patient. Based on Johnson's (1968, 1980) premise that illness as a noxious stimulus effects imbalance in the behavioral system of the human being, it was extrapolated that changes that occur in a patient's behavioral patterns would be perceived by the patient. Thus, changes would reflect the description of the imbalance in the patient's behavioral system, which needs to be identified and described in a systematic way. The description of change was envisioned in terms of (1) the perceived existence of change; (2) the direction of change--increase or decrease; (3) the quality of change--positive or negative; (4) the importance of change--its significance; and (5) the physical, psychological, or emotional effect(s) of the illness perceived as causally associated with the change.

Adult↗