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Biomedical subjects

J P Bush

Publications and source records attributed to J P Bush.

At least 19 recordsLinked to original sources
PubMed1994

Psychological preparation for pediatric oncology patients undergoing painful procedures: a methodological critique of the research.

Hypnosis and cognitive-behavioral packages are effective in preparing pediatric oncology patients for bone marrow aspiration and lumbar puncture. However, the relative efficacy of different preparations has not been determined, and potent components of preparation packages have yet to be identified. Further, factors hypothesized to moderate effectiveness of preparation (e.g., cognitive development) have not been investigated. Finally, due to a failure to employ process measures, the extent to which hypothesized mediators of behavior change (e.g., self-efficacy) are modified by preparation is unclear. Following an overview of empirical investigations, we make recommendations for addressing these limitations in future research.

Bone Marrow Diseases↗
PubMed1991

Factors affecting nurses' decisions to administer PRN analgesic medication to children after surgery: an analog investigation.

Investigated postoperative PRN analgesic medication decisions regarding children in 113 hospital nurses, using analog stimuli. Nurses with greater narcotics knowledge and comfort indicated they would provide significantly more medication. Nurses provided more analgesics to children showing higher pain, and on the first than on the third postoperative day. Seriousness of child's condition also affected medication decisions. On the first day, nurses gave less medication to the child with than without permanent sequelae, whereas on the third postoperative day nurses provided more analgesics to the child with than without sequelae. These findings were consistent across high and low pain conditions. Nurses' ratings of children's pain were also affected by seriousness and time since surgery. Findings are discussed with reference to problems of undermanagement of children's pain.

Adolescent↗
PubMed1991

The needleless syringe: efficacy of anesthesia and patient preference in child dental patients.

Delivery of local anesthesia in dentistry is primarily by way of a needle-tipped syringe. This procedure, when used on children, is often stressful and sometimes painful for the patient. The Syrijet is an instrument which delivers anesthesia without the use of a needle. This is accomplished by delivering the anesthetic solution under high compressive forces. The subjects were thirty-four children ranging in age between 5 and 15 years, on whom forty-five dental procedures were completed. There was a statistically significant difference in favor of the instrument, with twenty-five subjects reporting a preference for it. The instrument was completely successful in providing anesthesia in thirty-six of the forty-five procedures.

Adolescent↗
PubMed1990

Physical change, time of day, and child characteristics as factors in poison injury.

In a study of 85 children under 6 y whose mothers called the poison center, information regarding the physical surroundings of the substance ingested at the time of the incident was obtained along with ratings of maternal stress and child behavior problems. In 51% of the incidents, the substance had recently been moved from a usual storage site or was in use at the time of the ingestion. Environmental changes occurred in 1/3 of those poisoned between 4 and 6 pm which was the 2-h period of the greatest incidence. Poisoning in children 1 and 2 y were more likely to have followed physical environmental change. Children with higher child behavior problem score were more likely to be poisoned in the morning.

Age Factors↗
PubMed1989

Patterns of PRN analgesic drug administration in children following elective surgery.

Conducted chart review study of 114 4- to 14-year-olds hospitalized for elective surgery to investigate analgesic medication patterns. Correcting for body weight and different drug potencies, correlations were examined between analgesics, child age, painfulness of recovery, and seriousness of surgical procedure. Weight-adjusted analgesics prescribed and delivered PRN were unrelated to painfulness of procedure and age. Expert ratings of the seriousness of anticipated sequelae were found to be a modest but significant predictor of analgesics. Results suggest that PRN prescription of analgesics in children essentially guarantees very low drug delivery without achieving individualized pain management. Possible interpretations and suggestions for research into effects of practitioner attributions of seriousness on clinical decision making are discussed, along with implications for other explanations of inadequate analgesic practices.

Adolescent↗
PubMed1989

Psychomotor skills and incentive as predictors in a children's toothbrushing program.

Sixty-four children, four to twelve years of age, were seen in a pediatric dental clinic for routine dental examinations. Prior to dental treatment subjects were administered tests of visual-motor development and dental knowledge. Children were randomly assigned to a toothbrushing-instruction (individual training in horizontal scrubbing) or no-instruction group. Within each group, subjects were assigned to an incentive (promise of a special prize for brushing well) or no-incentive condition. Plaque score measurements and toothbrushing skills evaluations were performed at the initial appointment and at a one-week follow-up. Brushing skills were predicted by visual-motor skills and by dental knowledge. Level of visual-motor development predicted the likelihood of missing fewer oral areas, while brushing incentive was found to affect overall improvement in plaque removal regardless of instruction. Instruction affected improvements in brushing the more difficult molar teeth and lingual surfaces specifically.

Child↗
PubMed1988

Relaxation-induced anxiety in a subclinical sample of chronically anxious subjects.

Recent reports indicate that some individuals experience increased anxiety during formal relaxation training; however, there has been just one controlled investigation of this phenomenon (Heide and Borkovec, 1983). The present study was designed to replicate and extend the findings of Heide and Borkovec by providing evidence of "relaxation-induced anxiety" during one session of taped progressive relaxation training. Thirty chronically anxious subjects (21 females, 9 males) participated. Five subjects (17%) reported increased anxiety during the session. Personality measures indicated that relaxation-induced anxiety may be associated with an internal locus of control, a generalized fear of becoming anxious, and a fear of losing control.

Adolescent↗
PubMed1988

Situational anxiety and blood pressure lability in the physician's office.

In order to evaluate the association between situational anxiety levels and blood pressure variability during physician's office visits, 19 patients were assessed at the beginning of the visit and before and after being examined by the physician. Assessment included blood pressure measurement as well as self-report of current anxiety level. Previous findings that systolic readings do significantly diminish over the course of the visit were replicated for both hypertensive and normotensive patients, accompanied by correlative decreases in state anxiety. Diastolic blood pressure readings were more stable and less associated with fluctuations in state anxiety, except in patients with initially higher diastolic readings. Results were interpreted as indicating the importance of using more than one blood pressure measurement in diagnosing hypertension and monitoring its management. In particular, patients' anxiety responses upon entering the examining room may produce artificial elevations.

Adult↗
PubMed1986

Mother-child patterns of coping with anticipatory medical stress.

Maternal influences on children's fear and coping behaviors during a medical examination were studied in a pediatric outpatient clinic using the Dyadic Prestressor Interaction Scale (DPIS) to measure anticipatory reactions just prior to contact with the physician. Analysis of 50 mother-child dyads, including children from 4 to 10 years of age, revealed that the behaviors emitted by mother and child are likely to influence the child's ability to tolerate the medical experience. Maternal use of distraction and low rates of ignoring were associated with lower child distress and increased prosocial behaviors. Children's active exploration of the situation was more likely to occur when mothers provided their children with information, and was less likely when mothers reassured their children. Maternal reassurance of children and overt maternal agitation were associated with more maladaptive child responses. Age trends were also found in interactive patterns. Younger children were more likely to receive reassurance from mothers when they showed attachment. There was a stronger association between mother's information giving and child's exploring for children under 5 years, 9 months of age. Results supported the usefulness of the DPIS for investigation of child management techniques in this situation. Theoretical extension to attachment and stranger-approach situations was made. Suggestions for future studies to clarify the reciprocity of interactions or to determine causal direction between mother and child behaviors, as well as to evaluate the specificity or generality of these findings, were provided.

Age Factors↗