PubMed HealthSearch

Biomedical subjects

J Holcombe

Publications and source records attributed to J Holcombe.

7 recordsLinked to original sources

Neuman systems model used as a guide for the nursing care of an 8-year-old child with leukemia.

The Neuman Systems Model (NSM) provides a framework for holistic pediatric oncology nursing practice. In this article, an overview of NSM is given. This model is applied to an 8-year-old child with leukemia for the comprehensive assessment, planning, and evaluation of nursing care. A comprehensive list of nursing diagnoses is categorized by primary and secondary prevention.

Antineoplastic Combined Chemotherapy Protocols

Hope, social support and self-esteem of patients with spinal cord injuries.

A descriptive study was conducted to determine if a relationship among the variables of hope, social support and self-esteem existed in persons with spinal cord injuries. A demographic data sheet and three instruments were used: Miller Hope Scale (MHS), Personal Resource Questionnaire Part II (PRQ) and Rosenberg Self-Esteem Scale (RSES). Of the 83 inpatients and outpatients who agreed to participate, 77 sets of questionnaires were usable. Ages of subjects ranged from 18-73 (mean 34.8) years and levels of injury ranged from C4-L3. The mean scores on the tools were: MHS-153.51 (40-200 possible range), PRQ-137.42 (25-175 possible range) and RSES-29.59 (10-40 possible range). There was a statistically significant relationship between hope and social support, hope and self-esteem and social support and self-esteem. By multiple regression analysis, the best predictors of hope in the subjects were self-esteem, social support and education.

Adult

Hope, self-esteem and social support in persons with multiple sclerosis.

A descriptive study was conducted to determine if a relationship among the variables of hope, self-esteem and social support existed in persons with multiple sclerosis. A demographic data sheet and three instruments were used: Miller Hope Scale (MHS), Rosenberg Self-Esteem Scale and Part II of the Personal Resource Questionnaire (PRQ). Of 75 individuals contacted by mail asking them to participate, 40 sets of questionnaires were returned. The subjects' ages ranged from 32 to 70 with a mean of 48.2. The mean scores on the 3 instruments were: MHS--157.9 (40-200 possible range), self-esteem--29.68 (10-40 possible range), and PRQ Part II--141.13 (25-175 possible range). A statistically significant relationship was found between hope and self-esteem, hope and social support and social support and self-esteem. Additionally, findings were reported and conclusions and nursing implications identified.

Adult

Biosynthetic human growth hormone: current status and future questions.

Human growth hormone derived from human pituitaries resulted in excellent growth in children with growth hormone deficiency but limited supplies in many countries prevented treatment of all children, delayed the onset of therapy, and/or forced the use of doses that may have been less than optimal. Recent advances in technology allow the production of byosynthetic human growth hormone (hGH) by recombinant methods resulting in increased supplies of hormone. More than 200 previously untreated children with growth hormone deficiency have been evaluated for two years or longer while receiving biosynthetic natural sequence hGH (somatropin). The mean growth velocity of 3.6 cm/yr prior to therapy increased to 8.8 cm/yr after one year and 7.25 cm/yr in the second year. Growth response was inversely related to age when calculated as cm/yr. This response paralleled the normal decrease in growth velocity as children approach puberty. Children with hGH deficiency who had previously received replacement hGH were enrolled in a double-blind study using either 0.06 or 0.10 mg/kg thrice weekly for 12 months. Growth rate was significantly greater with the higher dose during the first six months but not during the second six month period. The use of a higher dose of hGH must be individualized as not all patients have accelerated growth with the increased dose and the mean group response is not permanent. Multiple questions remain unanswered after three decades of treating growth hormone deficiency. Are the current criteria for diagnosis of growth hormone deficiency appropriate? What dose of hGH is correct? Do children need increases in replacement therapy as their height approaches normal?(ABSTRACT TRUNCATED AT 250 WORDS)

Child

Detection of diabetic retinopathy by optometrists.

Optometrists examined 25 eyes with varying severity of diabetic retinopathy. No history or clinical information was provided to the optometrists who performed fundus examinations on dilated eyes using direct or indirect ophthalmoscopes. Color stereoscopic fundus photographs were independently graded and used as the standard. Optometrists made a correct diagnosis of whether retinopathy was present in 77% of the eyes (95% confidence interval (CI): 73%, 82%). They made a correct diagnosis of the type and degree of diabetic retinopathy in 57% of the eyes (95% CI: 39%, 75%). This diagnosis rate exceeded the rate reported for physician examiners (39%) and equaled that of general ophthalmologists (52%) in the only other similar study. Sensitivity for diagnosis of diabetic retinopathy in eyes of diabetic patients using only ophthalmoscopy was 74% (95% CI: 67%, 81%), while specificity for diagnosis of the absence of retinopathy was 84% (95% CI: 73%, 96%). 100% of these optometrists would have referred the eye with preproliferative retinopathy. 53% would have referred the eye classified as proliferative retinopathy without high risk characteristics, and 79% would have referred the eye with macular edema.

Adolescent