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Biomedical subjects

D Milne

Publications and source records attributed to D Milne.

At least 55 records · Page 3Linked to original sources
PubMed1988

A re-evaluation of the clinical psychologist in general practice.

Recent evaluations have questioned the early claims that psychologists make a valuable clinical contribution in general practice. In particular, it has been suggested that the promising outcomes have been the result of a 'worst year' phenomenon and that psychologists only slightly accelerate clinical improvement. This paper describes a small but relatively comprehensive evaluation of the work of a clinical psychologist. Analyses of economic and clinical data on 22 patients referred by the general practitioner indicated that the psychologist made a distinctive clinical contribution by improving personal coping strategies and reducing distress among patients with more chronic problems who did not show any such changes during a waiting list period. It is concluded that the recent negative evaluations of the clinical psychologist in general practice may have been misleading and premature.

England↗
PubMed1987

Parallel forms of the Knowledge of Behavioral Principles as Applied to Children questionnaire: an independent, multi-centred, British replication.

The psychometric properties of the test entitled Knowledge of Behavioral Principles as Applied to Children and two shortened forms of this test were investigated in two samples of British subjects. The first consisted of 162 psychiatric nurses, psychiatrists, occupational therapists, physiotherapists and clinical psychologists attending behaviour modification courses. The second consisted of 49 teachers and nurses, all working with the mentally retarded, who completed the test by post. The whole test and the two sets of parallel forms all showed good internal consistency and sensitivity to change. Some shrinkage during replication was found. The 25-item forms showed evidence of the properties of parallel forms (equal means, standard deviations and standard errors) in both samples. The 10-item forms were also parallel in sample 1. However the 10-item forms did not remain parallel in sample 2 and so cannot always be recommended.

Behavior Therapy↗
PubMed1987

Is a problem shared a problem shaved? An evaluation of hairdressers and social support.

Despite growing interest in social support as a moderator of stress, few studies have attempted to demonstrate the effects of a psychological intervention in this domain. Hairdressers are an acknowledged source of social support and a randomly selected group (n = 8) were given structured training in the provision of social support to their customers. In comparison with a group of their untrained colleagues (n = 7), repeated measures indicated a significant training effect in terms of the hairdressers' understanding and proficiency in providing social support, while a generalization effect was suggested by customers' ratings of their perceived 'helpfulness'.

Adaptation, Psychological↗
PubMed1987

Professional coping.

Explore the source record for details and available documents.

Adaptation, Psychological↗
PubMed1986

Effect of browned and unbrowned corn products intrinsically labeled with 65Zn on absorption of 65Zn in humans.

Experimental browned and unbrowned corn products were formulated and processed from unenriched, degermed yellow corngrits. The browned product (cornflakes) contained more insoluble dietary fiber and bound more zinc (in vitro) than the unbrowned product (corngrits). During processing some of the cornflakes and corngrits were combined with a small amount of yellow corn endospermhull intrinsically labeled with 65Zn. The intrinsically labeled corn products were fed, in a crossover design, as components of two breakfasts to six normal, unconfined volunteers. Each volunteer absorbed more 65Zn from the corngrits than from the cornflakes. The reduced 65Zn absorption from cornflakes was attributed to heating and toasting reaction products, possibly Maillard, which bound zinc and consequently made the zinc less available for absorption.

Absorption↗
PubMed1986

Planning and evaluating innovations in nursing practice by measuring the ward atmosphere.

A controlled evaluation of nurses' and patients' perceptions of the hospital ward atmosphere served to both define problems and evaluate the corrective changes that were implemented in a psychiatric day hospital. The results indicated that nurses and patients held similarly unfavourable views of the ward at a baseline assessment, including low levels of support, involvement, spontaneity and programme clarity. This finding then served as the basis for systematic changes, including staff training, the regrouping of patients, and revising the therapeutic programme. A repeat evaluation then indicated that these changes had significantly improved the ward atmosphere from the perspective of both nurses and patients. It is concluded that this approach holds considerable promise for the implementation of changes in nursing practice.

Adult↗
PubMed1986

Teaching behaviour therapy to psychiatrists with a structured learning format.

A 5-day, in-service training in behaviour therapy, which was attended by six psychiatrists, is described. The course covered principles of behavioural assessment and therapy within a structured learning format. The results of this systematic approach are presented in terms of six measures, administered before and after training. Two of these assessed attitudes to treatment, one gauged knowledge of behavioural principles and the remaining three evaluated the psychiatrists' skills in some key areas of behaviour therapy. Statistically significant improvements were found on the knowledge questionnaire and on one skill measure. These results were compared to those obtained by a control group (n = 18) and a course-trained group (n = 65) of qualified psychiatric nurses. The main conclusion drawn was that the course succeeded as an efficient learning programme, developing understanding and skills of value both clinically and in terms of collaborative teamwork.

Behavior Therapy↗
PubMed1986

Effect of dietary supplements on acute mountain sickness.

Four fit young men participating in a high altitude mountaineering expedition took part in a 15-day trial of two high-calorie dietary supplements. They ate either a high carbohydrate or a high fat supplement, alternating every 3 days. All dietary intake was recorded. Subjects completed a daily questionnaire assessing the severity of symptoms. Within a single-subject design no statistically significant differences were obtained between the severity of symptoms and dietary carbohydrate or total calories. This suggested that the dietary supplements had no effect on symptoms, a finding that is discrepant with the existing literature. However, we did find that subjects consumed more calories while on the high carbohydrate supplement.

Adult↗
PubMed1985

Effect of food supplementation (WIC) during pregnancy on birth weight.

Of 824 women screened, 410 were enrolled at midpregnancy in a prospective, randomized, controlled nutrition intervention study. Of these, 226 were predicted as likely to have small or large babies, 184 to have average-sized babies. Two hundred thirty eight mothers received USDA Women, Infants and Children (WIC) Food Supplementation vouchers from midpregnancy, 172 did not. Leukocyte protein synthesis (as a cell model) was significantly higher (p = 0.009) by 36 weeks gestation in supplemented mothers. Mean birth weight of their babies was greater, 3254 vs 3163 g, (+91 g) p = 0.039, adjusted for sex, gestational age, prenatal visits, pregnancy interval, smoking, and previous low birth weight infants. Controlling for entry weight obviated the significance of the difference, except for WIC supplemented smokers (greater than 10 cigarettes/day) whose babies were significantly heavier by +168 g (p = 0.017) than those of unsupplemented smokers. WIC partially protects fetal growth in smokers.

Birth Weight↗
PubMed1985

'The more things change the more they stay the same': factors affecting the implementation of the nursing process.

One of the biggest problems currently facing the nursing profession is that of implementing the nursing process. Innovations in health care often elicit obstructions, and objective data which might help us to understand and overcome these implementation problems are lacking. The present study considered these problems by contrasting two groups of psychiatric nurses both of whom had received an in-service course in behaviour therapy. One group went on to implement this training by conducting behavioural nursing care plans with their patients, whereas the second group did not do so. A retrospective analysis of 25 variables associated with these groups of nurses indicated that neither subject variables, test scores nor learning during the course were good predictors of the nurses' implementations of the nursing process. An alternative basis for predicting and facilitating implementation is discussed. This focuses on institutional variables which may exert more control over the use of the nursing process than the personal characteristics of individual nurses. The implications of this analysis are important for the selection, training and motivation of nurses.

Adult↗
PubMed1985

Review and replications of a 'core-course' in behaviour therapy for psychiatric nurses.

The advent of the nursing process and the success of behaviour therapy in psychiatry have created a need for a revised emphasis on nursing practice and education. This paper outlines an in-service, 'core-course' in behaviour therapy which addresses this need. The results from an initial and very comprehensive evaluation of the course are presented in terms of the attitudes, knowledge and skills of 65 nurses. We then give a summary of seven subsequent replications of the course in different British National Health Service psychiatric hospitals. These involved nurses in the organization and running of the core-course, and, together with the very favourable results, they illustrate one strategy for developing nurses' proficiency in behaviour therapy.

Aged↗
PubMed1985

An observational evaluation of the effects of nurse training in behaviour therapy on unstructured ward activities and interactions.

The effects of a five-day in-service training in behaviour therapy for psychiatric nurses were assessed by naturalistic observations in three NHS long-stay wards. The observations focused on nurses' and patients' independent and interactive behaviours as a function of the course of training, during an unstructured part of the ward programme. A comparison of the behaviourally trained nurses and their colleagues indicated that the training had produced no systematic effect on independent activities and was associated with significantly less frequent or appropriate interactions with patients. These findings were contrasted with the nurses' proficiency in their structured use of behavioural techniques and led to an interpretation of patient control over their use of these new skills in default of staff management procedures. More broadly, the findings were regarded as an elaboration of the respective roles of staff training and management in institutional change. They were also viewed as evidence that circumscribed and short-term evaluations may be contradicted by more 'ecological' evaluations, which unobtrusively observe the broader consequences of our interventions into systems. In the long term these consequences may ultimately determine the effectiveness of our training endeavours and hence there is a pressing need for more process evaluations of the present kind.

Adult↗
PubMed1984

The relevance of nurses' characteristics in learning behaviour therapy.

Factors that influence learning are of great interest to those concerned with health care. This is because they bear on the question of change in staff and patients. This study is a systematic investigation of the individual characteristics that the nurse brings to the learning situation and their association with change. The purpose of investigating this relationship is to clarify and pinpoint variables that may facilitate selection and predictions regarding learning. This in turn has great relevance for such aspects of nursing practice as patient teaching and in-service training. The study relates seven nurse variables to six measures of learning during an in-service course in behaviour therapy techniques for 65 qualified psychiatric nurses in the United Kingdom. The results suggest that some individual characteristics considered to impede learning, such as age, are unrelated. Other characteristics, such as academic qualifications, are expected to improve learning but were also found to be unrelated. The most significant associations were found for the relationship between prior knowledge and experience and measures of skill. The results are regarded as providing support for the argument of improved specification of both individual characteristics and learning. This improvement may lead in turn to modified nurse selection criteria, revised teaching methods, and to better patient care.

Adult↗
PubMed1984

The development and evaluation of a structured learning format introduction to behaviour therapy for psychiatric nurses.

A five-day in-service course in behaviour therapy for psychiatric nurses is described. The course utilized a structured learning format and systematized the progression from classroom to ward by introducing supervised single-case studies, although these were carried out by only a minority of trainees. This paper describes the comprehensive evaluation of a large-scale training programme, incorporating a control group design and 10 'outcome' measures. The evidence obtained from these measures indicated that the structured learning was effective in promoting knowledge and skills with behavioural techniques in the experimental group nurses (n = 41). There were no significant improvements in the scores obtained by the matched control group of nurses (n = 18). These results were maintained at a one-year follow-up assessment and indicated that psychiatric nurses can acquire and maintain behavioural techniques, and that they can apply them successfully with their long-stay patients. However, the proportion of nurses actually conducting the single-case study 'projects' was low. The implications of this are discussed in terms of the 'setting events' for projects in the ward.

Behavior Therapy↗
PubMed1984

Improving the social validity and implementation of behaviour therapy training for psychiatric nurses using a patient-centred learning format.

Low levels of behavioural care plan implementation and criticisms of the format of an earlier 'classroom' course led to a patient-centred approach to training psychiatric nurses. The critical change involved a series of practical learning tasks with patients on the ward, leading to a single-subject care plan. The 24 psychiatric nurses attending the new course achieved superior results on two of the skill measures by post-testing. They also conducted more care plans and credited the course with more social validity than their predecessors (n = 41). These findings are important in showing how training formats can overcome institutional constraints on service innovation.

Behavior Therapy↗