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Biomedical subjects

G van Servellen

Publications and source records attributed to G van Servellen.

At least 19 recordsLinked to original sources
PubMed2000

Building culturally sensitive substance use prevention and treatment programs for transgendered populations.

Studies show that transgendered individuals are at high risk for substance use problems. It is important to identify the unique needs and concerns of these individuals and culturally sensitive programs that will be successful in recruiting and retaining these individuals in drug abuse treatment services. This involves incorporating the needs of services from the perspectives of both the transgendered community and health-care professionals. It is the purpose of this article to discuss transgenderism as well as the substance use problems and difficulties within substance use treatment that transgendered men and women may face. This article presents guidelines for the design and evaluation of health-care services to transgendered populations.

Adolescent↗
PubMed1999

Can hospital structural and financial characteristics explain variations in mortality caused by acute myocardial infarction?

Each year 1 in 160 people in the United States suffers from acute myocardial infarction (AMI). Of these more than 1.5 million cases annually, 500,000 end in fatalities. This study's purpose was to describe and evaluate the role hospital characteristics play in rates of mortality caused by AMI in acute-care California hospitals. Characteristics evaluated include structural characteristics--i.e., teaching status, percentage of board-certified physicians, registered nurse hours per patient day (RN hours/patient day), volume of cases, technological resource availability, and urban density; and financial characteristics--profit status and total operating expenses per patient day. Although part of a larger investigation correlating mortality and length of stay, this article reports only the results for significant influences on mortality.

California↗
PubMed1999

Quality of life in women with symptomatic HIV/AIDS.

Despite the increasing incidence of cases of human immune deficiency virus (HIV) infection and of acquired immune deficiency syndrome (AIDS) in women, there is a serious lack of information about those women's quality of life (QoL). The purpose of this exploratory descriptive study was to describe QoL using an HIV-specific instrument (the HOPES) every 2 months over a 4-month period in a convenience sample of 44 women with symptomatic HIV/AIDS. Changes in physical, psychological, social, sexual dimensions, and overall QoL were evaluated along with the frequency of the most prevalent distressing items. The mean scores of the global QoL, physical and psycho-social summary scales were significantly different over the 4-month data collection period: quality of life improved. The most prevalent disruptions were in the psycho-social domain, including financial problems, worry about the family, distress about losing others from HIV, and worry about disease progression. The most prevalent physical disruptions included reduction in energy, difficulties with daily activities and frequent pain. Married women appeared to be more vulnerable to disruptions in QoL over time. In addition to the use of conventional disease-specific parameters for the ongoing follow-up of women with HIV/AIDS, the systematic use of a QoL assessment can provide a focused approach to monitoring problems and targeting interventions. Such an approach is especially important for nurses who assist women living with the symptoms of HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Demystifying the influence of hospital characteristics on inpatient mortality rates.

Death, although not the only measure of adverse outcome, has been studied more than any other single occurrence. The authors discuss the findings of these studies and propose a conceptual framework to explain the relation between several hospital characteristics (e.g., profit status, RN ratios) and inpatient mortality rates. These studies raise the issue of whether some hospital characteristics are distal contributors and others, such as RN ratios, are more proximal explanatory variables of the mortality rate. Implications for understanding the relation of nursing's role in the array of potential contributors are discussed.

Certification↗
PubMed1998

Women with HIV: living with symptoms.

This exploratory study used a semistructured interview to describe women's experiences coping with HIV-symptoms, their descriptors of their worst and best days, and their attempts to control symptoms. A convenience sample of 44 women, largely women of color, of lower socioeconomic status, unemployed, seeking treatment in one of six outpatient clinics in Los Angeles, were interviewed. Fatigue, the most frequently reported worst symptom, was present in 98% of these women. Feeling physically sick and having negative mood were mentioned most often in descriptions of worst days; being active, feeling physically healthy, and having positive mood were descriptors of best days. Of the total, 59% used rest/sleep to control symptoms, and this often was used in conjunction with healthy diet. The results of this study reveal aspects of women's day-to-day experiences with HIV-related symptoms.

Adaptation, Psychological↗
PubMed1996

Emotional distress in men with life-threatening illness.

This descriptive survey explored the relationship of health status, functional status, stressful life events, stress resistance resources and emotional distress in 60 men with life-threatening illness (N = 30 with cancer and N = 30 with AIDS). Sixty-two percent met CES-D criteria for clinical depression. This study's results supported the hypotheses that poorer functional status and greater negative stressors are associated with both higher levels of hopelessness and depression. Twenty-four patients constituted a group with severe emotional distress. This group was significantly different from the less vulnerable group with poorer functional status (KPS), a greater number and severity of negative stressors, less satisfaction with social support, and less hopefulness.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Personality hardiness, work-related stress, and health in hospital nurses.

Personality hardiness is a set of beliefs about oneself and the world one lives in. Hardier persons take control of their lives, believe that commitment to goals will result in positive outcomes, and perceive daily stressors as challenges. Hardiness has been linked with less stress and fewer health problems among various occupational groups. This study found that among 237 hospital nurses, work-related stress and emotional exhaustion were associated with greater health problems in the form of anxiety, depression, and somatic complaints. Hardier nurses reported less work-related stress, less emotional exhaustion, and less anxiety, depression, and somatization. This article discusses considerations for strengthening future studies concerned with the relationships between personality hardiness, work-related stress, and health in nurses.

Burnout, Professional↗
PubMed1992

Methodological concerns in evaluating psychiatric nursing care modalities and a proposed standard group protocol format for nurse-led groups.

The importance of detailing therapeutic effort and its outcome cannot be underestimated. The need to document outcomes has been re-emphasized in recent psychiatric mental health literature; however, the methodology for addressing threats to validity is well established. This article identifies the problems and issues related to a systematic evaluation of a therapeutic group intervention in an inpatient setting, specifically threats to validity, and describes the processes used in planning and implementing a standard group protocol format. The findings of this project depicting problems in the clarity and precision of documenting nursing practice are believed to be typical and generalizable. However, problems related to clarity and precision have not been addressed in the nursing literature. For a number of reasons, nursing staff members have not been sensitized to the importance of describing their practices in sufficient detail to allow others to replicate these practices. And yet, adequate evaluations of nursing efforts, particularly programmatic initiatives, require systematic testing with repeated trials. Although no description can describe in absolute terms what occurred, clear and precise descriptions of an intervention provide the foundation for valid conclusions about the effort. A detailed standard group protocol format provides a basis for establishing internal validity in subsequent quasi-experimental research designs as well as program evaluation studies.

Hospitalization↗
PubMed1991

Nursing-led group modalities in a psychiatric inpatient setting: a program evaluation.

This examination of group practice activities conducted by nurses in an inpatient setting combined retrospective examination of practices and concurrent analysis of what is actually done on the units. The most striking finding of this evaluation of institutional nursing-led or co-led group activities was the significant decline in the number of groups. Second, and a related finding, was the need to standardize the format for documenting group activities and outlining the scope and function of these groups. And finally, the need for concise evaluation criteria and measures to document the achievement of stated patient outcomes was very apparent.

Adolescent↗
PubMed1991

Patient satisfaction on AIDS and oncology special care units and integrated units: a pilot study.

The authors assessed patients' satisfaction with their nursing care in seven hospitals. Five of the hospitals utilized the special care unit (SCU) method of delivering care to AIDS or oncology patients; three had SCUs for AIDS patients. All seven of the hospitals had integrated units (IUs) where general medical, oncology, and/or AIDS patients were received in various proportions. Satisfaction with nursing care was measured with the Risser Patient Satisfaction Instrument. Patient satisfaction with nursing care was shown to be a function of delivery method; AIDS and oncology patients on SCUs expressed greater satisfaction with their care than medical, oncology, or AIDS patients on IUs (p less than .001). Patient satisfaction with nursing care was greater among whites than nonwhites. Also, some major sociodemographic and case mix variables, such as age, employment status, and diagnosis, were not associated with patient satisfaction directly; in other instances, the associations initially seen did not hold when delivery method (SCU vs. IU) and race were controlled for in a linear regression analysis.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Quality and cost of AIDS nursing care as a function of inpatient delivery systems.

Decisions to hospitalize persons with AIDS (PWAs) and the subsequent nursing process and outcomes associated with this hospitalization are of major concern to nurse administrators. Although decisions to hospitalize may be out of their control, events occurring during hospitalization that affect the quality of nursing care received are clearly the nurse administrator's responsibility. This report addresses a major issue concerning the care of PWAs: the decision to establish a dedicated AIDS unit. The effect upon both quality care and nursing care costs is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1990

The limitations of generic AIDS educational programs for the health professions.

Three major trends are driving the widespread need for continuing education in AIDS. First, with the spread of AIDS, increasing numbers of health care professionals are becoming involved in the care and treatment of AIDS, ARC and HIV positive individuals. Second, as the disease spreads beyond current AIDS epicenters, more persons with minimal information are required to have a baseline working knowledge of AIDS. Finally, the reluctance of many health care professionals to care for HIV-positive individuals, along with already existing staff shortages, limits access to care and makes the provision of responsive educational programs even more important. Generic programs to educate health professionals frequently lack sufficient specificity and sensitivity to address the needs of health professionals with varying levels of knowledge and role responsibility. This paper briefly summarizes the literature on the similarities and differences in knowledge and attitudes across and within professional groups. In addition, it presents specific research designed to provide initial direction for considering the circumstances under which health professionals, particularly nurses and physicians, may or may not profit from generic programs aimed at mixed levels and types of health care provider.

Acquired Immunodeficiency Syndrome↗
PubMed1990

The stresses of hospitalization among AIDS patients on integrated and special care units.

This study examined the stresses of hospitalization in AIDS patients and assessed the extent to which two different inpatient delivery systems differed with respect to perceived stresses in these patients. Patients from four AIDS dedicated special care units (SCU's) and five AIDS integrated units (IU's) in eight acute care hospitals were surveyed using a modified version of the Volicer Hospital Stress Rating Scale. Stresses related to loss of independence, separation from loved ones and problems with medications were experienced equally by both groups of patients. However, SCU patients had lower total hospital stress scores than IU patients in terms of the number of stresses experienced (p = 0.008) and how bothersome these stresses were perceived to be (p = 0.02). Additionally, patients on IU's more frequently experienced and were bothered by factors associated with ambiguity about their care and condition and feelings of abandonment and impersonal or discriminatory treatment.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Maladaptive coping in the critically ill population with acquired immunodeficiency syndrome: nursing assessment and treatment.

A diagnosis of the acquired immunodeficiency syndrome (AIDS) is a devastating experience, placing those with the syndrome at high risk for ineffective coping. During the acute stage of illness, when the patient is admitted to a critical care setting, a crisis can ensue and precipitate intense anxiety, anger, denial, depression, and even suicidal ideation. Although it is imperative that critical care nurses become proficient in accurately assessing, diagnosing, and treating the disease in individuals who have an increased risk of maladaptive coping, there is no systematic basis for assessing the coping of patients with AIDS. Our purpose is to present a theoretically based explanation of the coping experience of persons with AIDS and to delineate nursing interventions designed to deal with maladaptive responses. The early and deliberate assessment, diagnosis, and treatment of such responses by means of a full range of psychosocial interventions are needed to enhance the coping efforts of the patients and optimize their psychosocial adjustment.

Acquired Immunodeficiency Syndrome↗