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Biomedical subjects

D H Joseph

Publications and source records attributed to D H Joseph.

11 recordsLinked to original sources
PubMed1994

Risk taking and its influence on metabolic control: a study of adult clients with diabetes.

Clients afflicted with diabetes are routinely faced with making decisions about insulin control, diet, exercise and skin care. The specific aims of this study were (a) to determine if clients with controlled blood sugar levels were more likely to have risk-averse information processing styles and, (b) to determine the extent to which the differences in blood sugar levels were attributed to information processing styles, after controlling for knowledge of diabetes, participation in home monitoring, and age. A comparative design utilizing 86 insulin-dependent male and female clients with diabetes was used. Findings indicated that there were no differences in risk scores between uncontrolled and controlled diabetics. Additionally, in this study there were no differences in control between clients who were knowledgeable and those who were not. This study has several implications for nursing practice. As taking risks may not be as dangerous to the diabetic client's wellbeing as many believe, there may be a need to consider this behaviour in developing the client's plan of care. Questions are also raised about the influence of knowledge on control.

Adult↗
PubMed1985

Sex-role stereotype, self-concept, education and experience: do they influence decision-making?

The purpose of this study was to investigate the effects of self-concept, sex-role stereotype, educational preparation and years of experience upon the nurse's attitudes regarding decision-making. The Joseph Decision-making Tool (JDMT) was designed by the investigator to measure nurses' attitudes regarding decision-making. The tool consists of 20 scenarios in which the subject is asked to make a decision regarding a patient problem. Having an alpha reliability of 0.79, the JDMT was found to be exceedingly useful and easy to administer. Self-concept was measured by the BEM Scale. A heterogeneous population of female staff nurses working in medical-surgical units of two large metropolitan hospitals was used. A stepwise multiple regression technique was used to measure the potency of the particular variables in question. In a selected sample of 85 nurses, it was found that nurses with masculine sex-type scores and diploma education (P less than 0.05) felt that nurses should assume responsibility for decision-making. Experience was found to have an inverse relationship (P less than 0.01) with the JDMT. The more experience the nurse has, the less willing she is to make decisions. The majority of nurses (62%) who participated in the study were found to have androgynous rather than feminine sex-role stereotype scores. These two findings indicate changing trends in the traditional view of staff nurses. These new findings will assist nurses in changing the current image of a typically feminine nurse with a low self-concept. This study found strengths in nurses that are often overlooked by the feminists when they study nurses.

Adult↗
PubMedDate not supplied

A decision-making algorithm for blood pressure measurements.

Reliance on invasive blood pressure techniques can be problematic for nurses working in critical care units, as discrepancies are frequently noted between cuff and invasive blood pressure readings. Critical care nurses need a repertoire of decision-making techniques that assist them when they are caring for clients with this type of discrepancy. This paper describes an algorithm based on analytical techniques which is helpful to the nurse in making decisions about whether the invasive or noninvasive pressure is accurate.

Adult↗
PubMedDate not supplied

Strategies for teaching decision making: discrepancies in cuff versus invasive blood pressures.

With advanced technology the nurse has multiple assessment information to consider at once. Sometimes the data from different assessment modes conflicts and the nurse needs to evaluate the discrepancies to determine the most reliable assessment measurement. Teaching nurses clinical decision making is more difficult than before because of this increase in the amount and complexity of the data. These authors show how using an algorithm helps to teach decision making. They describe the use of an algorithm as a teaching tool for a course on evaluating the differences in cuff versus invasive blood pressure readings.

Bias↗
PubMedDate not supplied

Risk: a concept worthy of attention.

Clients often engage in behavior that involves risk. Consequences of this behavior are sometimes harmful, but not always. Many times clients' views of the risks they are taking are often based on personal decisions they have made about their own health. People who take risks are frequently quite knowledgeable. The author uses case studies to examine the concept of risk. The author posits that teaching plans must account for the risks that clients take. Teaching plans should reflect that risks/benefits need to be discussed. Teaching should reflect respect for patient choices. An open discussion with the client that reflects what is really happening in the client's everyday life is of far more value than scanty, often glossed-over reports clients are accustomed to giving health professionals.

Choice Behavior↗
PubMedDate not supplied

Cognitive therapy: a well-thought-out strategy.

Designing strategies for nursing care is a complex process. Carefully evaluating the nature of the client's problem is a beginning step in the eventual design of a strategy. In this case a careful review of the problem of depression led to the discovery of faulty reasoning mechanisms used by clients who experience depressive episodes. Once the theoretical roots of the problem become clear, the design of the strategy is a natural progression. The success or failure of a strategy is measured by research. The author uses selective examples to describe how various aspects of cognitive therapy can be incorporated into the client's plan of care.

Adult↗
PubMedDate not supplied

Videotaped focus groups: transforming a therapeutic strategy into a research tool.

Focus groups have become a popular method of collecting data for research projects. The addition of using a videotaped approach has broad implications for researchers, as it allows constant replay of the session. Although on the surface this approach seems straightforward and easy to use, the authors caution that this is not an approach for the novice. Investigators planning to use a focus group method must be well versed in group process. There is an unpredictable nature to the focus group process, and researchers need to prepare for the inevitable mishaps that lead to lost opportunities for data collection.

Data Collection↗
PubMedDate not supplied

Peer coaching: an intervention for individuals struggling with diabetes.

PURPOSE: The purpose of this study was to determine the value of peer coaching and its influence on behavior change. METHODS: Coaches who were known to be successfully managing their diabetes were paired with individuals who were struggling with behavior change associated with managing diabetes. The pairs were matched according to age, sex, and physical appearance. Coaches met initially with participants in a face-to-face meeting for 1 hour and talked with them once a week for 10 to 15 minutes for the next 8 weeks. The initial interview and subsequent phone conversations focused on the person's problems and efforts at behavior change. RESULTS: At the end of the study, the pairs participated in a videotaped focus group to discuss their views on coaching and its influence on behavior change. Participants reported that coaching was personal, useful in disease management, and helpful in their quest to establish and adhere to routines of care. Participants also reported making progress toward changing their behavior related to diet, exercise, and blood glucose monitoring. Sustained behavior change was not measured. CONCLUSIONS: Peer coaching appears to have merit as a viable, low-cost intervention with the potential of helping individuals with diabetes who need to change their behavior.

Diabetes Mellitus↗
PubMedDate not supplied

Risk taking among diabetic clients.

Diabetic clients must make daily decisions about their health care needs. Observational and anecdotal evidence suggests that vast differences exist between the kinds of choices diabetic clients make and the kinds of chances they are willing to take. The purpose of this investigation was to develop a diabetic risk-assessment tool. This instrument, which is based on subjective expected utility theory, measures risk-prone and risk-averse behavior. Initial findings from a pilot study of 18 women clients who are on insulin indicate that patterns of risk behavior exist in the areas of exercise, skin care, and diet.

Adult↗
PubMedDate not supplied

Struggling with behavior changes: a special case for clients with diabetes.

Health professionals expect clients with diabetes to change multiple behaviors as a way to decrease the risk of complications of the disease. The purpose of this study was to gain an in-depth understanding of the client's response to lifestyle change expectations. Using the transtheoretical model of change as framework for this study, clients were asked to address the level of difficulty they encountered when making lifestyle changes relating to their diabetes. Ten clients who participated in a taped telephone survey and a videotaped focus group reported that most change was difficult but not impossible. Most clients admitted that maintaining changes was a continuing battle. Both the transcripts and focus group revealed a wide variation in the clients' understanding of self-management. It was evident that successful management involves a fairly high level of cognition as well as willingness to change. Successful management involves thinking through and comprehending how diet, exercise, and medication relate to blood glucose levels. This preliminary study will be used as the basis for a more inclusive study that will focus on developing interventions that relate directly to helping clients change behavior.

Adaptation, Psychological↗