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Biomedical subjects

J K Schneider

Publications and source records attributed to J K Schneider.

18 recordsLinked to original sources
PubMed1999

Home-based leg strengthening for older adults initiated through private practice.

BACKGROUND: Leg strength correlates with functional ability in the frail elderly, many of whom can be reached through a private practice setting. The purpose of this study was to demonstrate the feasibility of physician-prescribed, home-based, clinic-monitored, high-intensity leg-strengthening treatment among elderly patients with a variety of medical problems. METHODS: Twenty-two elderly patients with a variety of chronic medical conditions were invited to participate during regularly scheduled office visits if they had difficulty rising from a chair and an unsteady, cautious gait (age 85.1 +/- 5.7, 14 female). Physical therapists (PT) instructed patients to lift ankle weights at home, three times per week. Patients visited PT five times over a 12-week period. Weights were increased at each visit. RESULTS: Patients' one-repetition maximum increased (right leg 13 to 21 lb, P = 0.00; left leg 15 to 22 lb, P = 0.00). Patients also improved in habitual (18 to 12 s, P = 0.01) and tandem (38 to 26 s, P = 0.00) 20-foot walking times and sit-to-stand time (5 to 3 s, P = 0.01). CONCLUSION: The primary care physician can initiate a home-based leg-strengthening program that is practical for and well tolerated by the frail elderly.

Aged↗
PubMed1999

Preliminary testing of the Episode-Specific Interpretations of Exercise Inventory.

The purpose of this study was to develop the Episode-Specific Interpretations of Exercise Inventory (ESIE). Through a qualitative analysis of women's exercise experiences, episode-specific interpretations were defined operationally as consisting of five themes (Somatic Sensations, Affirmations, Connectedness, Explanations, and Reflections), each containing several categories. Nine-point adjectival scales were generated to represent these five qualitative themes. Older women (N = 364; mean age 69.5 +/- 6.7) completed the ESIE, the Exercise Benefits and Barriers Scale (EBBS), and three counterbalanced exercise behavior measures. Common factor analyses of the ESIE items resulted in nine factors. This measurement model was trimmed to six factors using structural equation modeling. Correlations with EBBS subscales and differences between high and low exercisers supported construct validity of the ESIE subscales.

Aged↗
PubMed1997

Self-regulation and exercise behavior in older women.

The contribution of sensations and their interpretations during exercise were examined to understand exercise behavior in older women. Participants (N = 364) completed instruments measuring episode-specific and general interpretations of exercise, exercise behavior, and demographic variables. Results showed that episode-specific interpretations accounted for unique variance in exercise behavior after the effects of age and general interpretations were removed. Age and amount of concentration placed on feet and bodily movements were negatively related to perceived exercise behavior, whereas perceived exercise benefits were positively related to exercise behavior. Episode-specific interpretations are more immediate than general interpretations, making them a prime target for intervention.

Aged↗
PubMed1996

Work activities at an ambulatory care pharmacy with an integrated model of pharmacy practice.

Activities performed by pharmacists and technicians in an ambulatory care pharmacy were evaluated by work sampling to determine circumstances in which pharmacist time was used ineffectively. Over a two-week period, pharmacists and technicians in the outpatient pharmacy at University of Utah Hospitals and Clinics recorded their activities at random intervals during the workday. The data were analyzed by using descriptive statistics and an institution-specific index of pharmacist efficiency. During the study, 1565 pharmacist observations and 1465 technician observations of work activities were collected. Pharmacists spent 50% of their shifts on clinical and professional activities, while technicians spent 50% of their shifts processing prescriptions and 30% of their shifts directly supporting pharmacists clinical and professional activities. The efficiency with which pharmacists used the available work time for patient care was 56% (100% would mean that they spent all available work time on patient care activities). During a shift, 2.3 minutes per prescription per pharmacist was available for professional and clinical activities. Self-reported work sampling enabled the ambulatory care pharmacy staff to identify staff use of time.

Hospitals, University↗
PubMed1996

Validity of self-administered symptom scales in clients with schizophrenia and schizoaffective disorders.

Few studies have used self-administered symptom scales as outcome measures with individuals who have schizophrenia. However, with the increase in community-based treatment for the serious and persistently mentally ill and the emphasis on client empowerment, their ability to monitor and report symptoms needs to be assessed. Two forms of self-administered items, symptom distress statements and symptom intensity statements, were formed from 10 BPRS symptoms and administered to 29 individuals with schizophrenia. Both forms of self-administered items were highly correlated with BPRS items, supporting concurrent validity. Self-administered responses for positive symptoms of schizophrenia and nonpsychotic symptoms may be more valid than self-administered responses for negative or deficit symptoms.

Adult↗
PubMed1995

Alcohol, cannabis, nicotine, and caffeine use and symptom distress in schizophrenia.

The high prevalence of substance use, e.g., alcohol and illegal and nonprescribed drugs, in schizophrenia is widely recognized. One explanation for this high prevalence is that substance use may be a self-initiated method for managing symptoms. To test whether the intake of four substances--alcohol, cannabis, nicotine, and caffeine--would increase with increases in symptom distress, daily self-reports of symptom distress and substance intake over 12 weeks were analyzed with pooled time series analyses. Compliance with neuroleptic medication was added to the analyses to control for any changes in prescribed medication compliance while using nonprescribed drugs or alcohol. Of the four substances studied, only nicotine was significantly related to symptom distress. Higher distress with prodromal symptoms was related to decreases in nicotine use. Analysis of caffeine did not meet the criteria for significance but does provide direction for further research. Higher distress, with neurotic symptoms, was related to increases in caffeine use. Further research is needed to clarify the relationship between nicotine and symptoms.

Adult↗
PubMed1994

Assessment of pharmaceutical care needs in an ambulatory setting.

The authors assessed the perceived pharmaceutical care needs of ambulatory pharmacy patients based on their demographic characteristics and desired service mix. A questionnaire was given to repeat ambulatory pharmacy patients for 30 consecutive weekdays during April and May 1992 to assess patient satisfaction with current and future services. A total of 152 surveys were completed by patients while waiting for prescriptions to be filled. Overall, responses were favorable considering the existing level of services provided by pharmacists. More than 70% of all respondents were in favor of talking with a pharmacist about their prescriptions, receiving easy to understand advice on potential problems, and having their prescriptions thoroughly explained. Current dispensing services were also viewed as highly satisfactory by a majority of respondents. However, some patients apparently need more information regarding convenience services. Such information helps establish a profile of ambulatory patients so that an optimal service mix can be provided.

Ambulatory Care↗
PubMed1993

A place to be yourself: empowerment from the client's perspective.

This article describes a focused ethnography of a group of chronically mentally ill clients who were involved in a client-run drop-in center. Spradley's (1979) Developmental Research Sequence guided the research. Data were obtained from interviews, participant-observation and documents review. The qualitative analysis identified the major theme of empowerment, which had four process domains: participating, choosing, supporting and negotiating. These domains represented four levels of empowerment for this group. From the client's perspective, empowerment meant they participated more in the community, their choices were increased, they provided support for each other and they negotiated on a more equal basis with staff. A fifth domain, personal significance, described the effects of empowerment for each individual.

Community Mental Health Services↗
PubMed1993

A medication discharge planning program: measuring the effect on readmissions.

Repeated hospitalizations result in high costs and may occur as a result of patient errors in their medication regimen. To reduce rehospitalizations (hospitalizations within 31 days of the previous discharge), health care professionals have turned to the discharge planning process. Using Orem's theory of self-care, a medication discharge planning program was developed to provide instruction on the requisites necessary for medication self-care. The purpose of this pilot study was to examine the effects of this program on readmissions within 31 days. Five nurses implemented the program for 54 patients with an admitting diagnosis of congestive heart failure. These patients were alternately assigned to a control or an experimental group. The experimental group received the medication discharge planning program. The control group received the usual informal discharge planning provided on the nursing unit. Eight (28.6%) of the 28 patients in the control group were readmitted within 31 days of the previous discharge. Two (7.7%) of the 26 patients in the experimental group were readmitted within 31 days. These results showed a statistically significant difference using Fisher's Exact Test (p = .05). Those receiving the medication discharge planning program were less likely to be readmitted, suggesting the importance of a medication discharge planning program.

Adult↗
PubMed1993

Applying a political model to program development.

Politics encompasses personal behaviors that dominate much of day-to-day decision-making in organizations. Conflict arises when various groups with different goals, interests, values and perceptions attempt to influence policy or decision making to meet their own interests, needs, goals or values. In this paper, Baldridge's political model is used to analyze the conflict experienced in development of a hospital-based discharge planning program.

Decision Making, Organizational↗
PubMed1992

Clinical nurse specialist: role definition as discharge planning coordinator.

Changes within the health care system have forced hospitals to address two objectives: reduction in the number of patients who exceed the mean length of stay, and reduction in readmission rates. Many health care organizations have turned to the discharge planning program for assistance in meeting these objectives. The development of a discharge planning program is extensive and multifaceted. For the program to be effective, the coordinator of the program requires expertise in various roles including administrator, practitioner, consultant, educator, and researcher. Such a mission is especially suited for the advanced knowledge and expertise of the CNS.

Consultants↗
PubMed1992

Adverse drug reactions in an elderly outpatient population.

The prevalence of adverse drug reactions (ADRs) in elderly outpatients was investigated, along with factors that might be associated with their occurrence. The medical records of elderly patients attending an interdisciplinary geriatric clinic and a general medical clinic during 1988 were audited to collect a variety of demographic and treatment data and to detect documentation of first-time ADRs. Subjects were classified as having had an ADR if a physician documented this or if a relevant symptom was noted in the record and a score of 1 or above was obtained on the Adverse Drug Reaction Probability Scale. The presence of potential drug interactions was also assessed. The sample size was 463 patients, of whom 332 attended the medical clinic and 131 attended the geriatric clinic. Potential drug interactions were identified in the records of 143 subjects (31%). There were 107 documented ADRs in 97 patients (21%). Of these patients, 86 were noted by the physicians as having had an ADR. Twelve patients were hospitalized as a direct result of an ADR. Significant risk factors for ADRs were attendance in the geriatric clinic, the use of potentially harmful drug combinations, and the use of drugs that require therapeutic monitoring. Patient age and the number of drugs had no association with ADRs. In the elderly population studied, patients with frailty arising from multiple pathologies were more likely to have ADRs than the more robust elderly, even when their therapeutic regimens were simplified.

Adverse Drug Reaction Reporting Systems↗
PubMedDate not supplied

Psychometric evaluation of the Program Evaluation Instrument.

Most continuing education program evaluations are developed informally with little attention paid to psychometric properties. Rigorous evaluation of continuing education programs should measure quality and allow valid comparisons across programs. The Program Evaluation Instrument (PEI), which evaluates continuing education programs, was tested in this study to further evaluate its psychometric properties. The 19-item instrument consists of four theoretical subscales: program objectives, learner objectives, teacher behavior, and program satisfaction. Participants (N = 566) completed the instrument after a variety of hospital continuing education programs. Principal components factor analysis with Varimax rotation revealed two interpretable factors, Preparation and Presentation, and Usefulness. Coefficient alphas for the two factors were .94 and .70 respectively. The findings suggest item revision and further psychometric evaluation.

Education, Nursing, Continuing↗