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Biomedical subjects

D Y Brockopp

Publications and source records attributed to D Y Brockopp.

15 recordsLinked to original sources

Barriers to change: a pain management project.

Although considerable effort has been directed toward improving the management of acute pain, ineffective pain management practices remain in many institutions across this country. While educational efforts have increased health care providers' knowledge regarding the management of pain, a concomitant change in practice has not occurred. This project was designed to examine barriers to the effective management of pain encountered in acute care settings. A repeated case study of attempts to change was conducted in six institutions located in the southeastern United States. Results identified seven major barriers to pain management: lack of knowledge, non-facilitative attitudes, inconsistent leadership, poor working relationships, cultural and religious biases, physicians' fears of legal repercussions and a lack of resources.

Acute Disease

Elderly hospice patients' perspective on pain management.

The literature reports that 70% of cancer patients with advanced disease experience pain. Even with increased emphasis on research and education, problems with effective pain management are still evident. Hospice patients' knowledge and attitudes about pain may contribute to this complex problem. To gain an understanding of hospice patients' perspective on the management of pain, 57 hospice patients were asked to describe their knowledge of pain management and their attitudes toward controlling pain. Results showed non-facilitative attitudes and gaps in knowledge that may contribute to ineffective pain management among hospice patients.

Aged

Evaluation of self-esteem of women with cancer receiving chemotherapy.

PURPOSE/OBJECTIVE: To examine the concept of self-esteem as it relates to female patients with cancer before diagnosis and while experiencing chemotherapy-induced alopecia. DESIGN: Descriptive-analytic. SETTING: Oncology unit of a community hospital and an outpatient oncology clinic in a southeastern city of the United States. SAMPLE: 30 women receiving chemotherapy and who have experienced some degree of alopecia. METHODS: Subjects answered demographic questions and were evaluated for degree of hair loss. Subjects completed the Cantril Self-Anchoring Scale (CSA) on the day of the interview and retrospectively prior to their diagnosis. In addition they completed the Rosenberg Self-Esteem Scale (RSE). MAIN RESEARCH VARIABLES: Self-esteem, change over time, degree of alopecia, length of time since diagnosis. FINDINGS: A significant decrease in self-esteem from before cancer diagnosis levels to time of experiencing chemotherapy-induced alopecia; modest correlation between the CSA and the RSE. Four categories of characteristics (physical, spiritual, psychological, social) influencing self-esteem emerged from analysis of the CSA responses. CONCLUSIONS: Self-esteem was not stable in this group of women. Postdiagnosis levels were lower than those before the diagnosis; however, lower levels did not necessarily translate into low self-esteem. The CSA may be a more comprehensive and sensitive measure of self-esteem in patients with cancer because it is based on individual definitions of high and low self-esteem. IMPLICATIONS FOR NURSING PRACTICE: Understanding what specifically may lower an individual's self-esteem can be useful in identifying patient-specific interventions. Future research must explore ways to determine self-esteem consistently and easily.

Adult

Nursing knowledge: acute postoperative pain management in the elderly.

1. The inadequate management of acute postoperative pain among adults is well documented. Studies have shown that 75% or more of hospitalized adult patients following surgery suffer moderate or intense pain even with the use of analgesics. Also, physicians under-prescribe narcotic analgesics and nurses administer less than the patient could receive. 2. Nurses' ineffective approaches to the management of pain have been attributed to inappropriate fears of addiction and respiratory depression, rigid attitudes regarding what constitutes adequate pain relief, and misunderstandings about the physiologic and psychologic components of pain. 3. The results of this study support McCaffery's (1989) finding that nurses do not understand the effective use of narcotics in relation to pain management.

Adult

The role of prior pain experience and expectations on postoperative pain.

The present study was designed to examine previous pain experiences as they relate to expectations of postoperative pain. In the study, 101 patients aged 55-87 (47 men, 54 women) participated in a structured interview that examined 13 factors thought to be associated with presurgical expectations of postsurgical pain. These factors relating to prior pain experience were identified from the literature as well as the experience of clinicians in the areas of anesthesiology, nursing and psychology. The two variables that correlated significantly (multiple r = 0.51) with pain expected postoperatively were: a single item from the general attitude questionnaire about pain (pain is to be expected after surgery even with medicine) and the total of the global ratings of past pain experience. A follow-up study will examine these variables in relation to actual pain experience.

Aged

Fiscal and clinical evaluation of patient care. A case management model for the future.

The cost of healthcare within the United States continues to climb as does the number of individuals who have limited access to the healthcare system. By the year 2000, healthcare costs are predicted to comprise 15% of the gross national product. Over the last 10 years, the number of Americans who do not have financial protection from medical costs has risen dramatically. Presently, an estimated 35 million individuals have no insurance or other coverage.

Adult

Personal control and the needs for hope and information among adults diagnosed with cancer.

Cancer patients inevitably experience situations in which their sense of personal control is diminished. Identifying the strategies used by these individuals to maintain or regain control can be an important component in the planning of care. This study examined the relationship between levels of perceived personal control and the needs for hope and information among 56 adult cancer patients. Subjects responded to the Needs Assessment Inventory and the Spheres of Control Scales. Data were analyzed using responses from the total group (n = 56), male subjects (n = 23), and female subjects (n = 33). Significant correlations were found between perceived level of control and eight issues related to hope and information-seeking.

Adult

Eating disorders: a teen-age epidemic.

This article presents a personal and professional view of two eating disorders that are presently affecting large numbers of adolescents and young adults throughout the country. Bulimia and anorexia nervosa may be prevented and treated if the public receives sufficient and appropriate education.

Adolescent

What is NLP?

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Communication

The effect of a mock trial on nursing students' ability to make clinically sound legal judgments.

In an attempt to enhance nursing students' abilities to make legally sound clinical judgments, a mock trial experience was developed and evaluated. Using a quasi-experimental design, students' learning was assessed using scenarios derived from actual cases involving nurses. Satisfaction with a traditional learning approach was compared to learning through attendance at a mock trial. A significant difference was found in learning before and after the trial (t = 2.26, P < 0.05), and students preferred the mock trial experience to traditional classroom presentations.

Clinical Competence