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Biomedical subjects

K L Soeken

Publications and source records attributed to K L Soeken.

At least 19 recordsLinked to original sources
PubMed2003

Herbal medicines for the treatment of rheumatoid arthritis: a systematic review.

OBJECTIVE: With the growing interest in herbal therapies among persons with rheumatoid arthritis, there exists a need for investigation into their safety and efficacy. The purpose of this study was to conduct a systematic review to examine the evidence for the use of herbal medicines for RA based on randomized clinical trials (RCTs). METHODS: A computerized search of eight electronic databases and the bibliographies of identified articles resulted in 14 studies meeting the inclusion criteria. Two raters independently extracted data and rated the trials for quality. RESULTS: There is moderate support for gamma-linolenic acid (GLA), which is found in some herbal medicines, for reducing pain, tender joint count and stiffness. For other herbal medicines there was only a single RCT available, resulting in weak evidence. In general, herbal preparations were relatively safe to use. CONCLUSIONS: Given the number of herbal medicines promoted for RA, further research is needed to examine their efficacy, safety and potential drug interactions.

Arthritis, Rheumatoid↗
PubMed2001

Mental health services for youths in foster care and disabled youths.

OBJECTIVES: This study assessed whether mental health services for youths differ with respect to medical assistance aid category. METHODS: Computerized claims for 15,507 youths with Medicaid insurance in a populous county of a mid-Atlantic state were used to establish population-based prevalence estimates of mental disorders and psychotherapeutic treatments during 1996. RESULTS: An analysis of service claims revealed that the prevalence of mental disorders among youths enrolled in foster care (57%) was twice that of youths receiving Supplemental Security Income (SSI; 26%) and nearly 15 times that of other youths receiving other types of aid (4%). Rates of mental health service use were pronounced among foster care youths aged 6 to 14 years. Attention deficit/hyperactivity disorder, depression, and developmental disorders were the most prevalent disorders. Stimulants, antidepressants, and anticonvulsants were the most prevalent medications. CONCLUSIONS: Youths enrolled in foster care and youths receiving SSI use far more mental health services than do youths in other aid categories. Additional research should evaluate the complexity and outcomes of mental health services for youths in foster care.

Adolescent↗
PubMed2001

Pain experiences of traumatically injured patients in a critical care setting.

BACKGROUND: Little is known about the acute pain experiences of traumatically injured critically ill patients. OBJECTIVES: To describe pain experiences of traumatically injured adults during the first 72 hours of hospitalization. METHODS: Thirty multiply injured adults at a level I trauma center participated in the study. Pain was measured by using the McGill Pain Questionnaire and a visual analog scale. Subjects completed pain measures while at rest in a supine recumbent position and after a turn onto the side. RESULTS: The typical subject was 37 years old, had 4 major blunt trauma injuries, and had received the equivalent of 55.9 mg of morphine during the 24 hours before data collection. Mean at-rest scores were 26.5 on the pain-rating index, 2 on the present pain intensity index, and 34.6 on the visual analog scale. Immediately after the turn, mean scores on the visual analog scale increased from 25 to 48.1 (P = .002). Other pain scores after the turn did not differ significantly from at-rest values. Subjects who turned had lower scores on the visual analog scale at rest (P = .02) and less anxiety (P = .02) than did those who refused to turn. Ninety-six percent reported pain in the injured areas, and 36% reported pain related to biomedical devices. No relationship was found among reported pain and demographic, treatment, or clinical variables. CONCLUSIONS: Additional research is needed on pain at rest and during commonly performed procedures and on improved methods for pain relief in traumatically injured critically ill patients.

Academic Medical Centers↗
PubMed2000

Social support transactions between professional and nonprofessional women and their mothers.

A theoretical model predicting professional and nonprofessional women's perceptions of social support transactions with their mothers was tested. A sample of 210 Professional women and 165 nonprofessional women answered mailed questionnaires. LISREL VI was used to evaluate the quality of the measurement model and generate a revised model. Social support was greatest when employed women were professional, had positive filial responsibility attitudes, lived near their mothers, visited them frequently, and when mothers were not married. These findings provide a beginning theoretical model that can serve as a basis for nursing practice and research when working with intergenerational families.

Adult↗
PubMed2000

Risk factors for nosocomial pneumonia in critically ill trauma patients.

Nosocomial pneumonia is the most common pulmonary complication in trauma patients and the leading cause of death in nosocomial infections. A comprehensive review of pneumonia studies is provided. The Centers for Disease Control's nosocomial pneumonia pathogenesis model is reviewed and was used to guide the selection of risk factors evaluated in this study. The purposes of this research were to identify underlying dimensions (factors) of variables that increase the risk of nosocomial pneumonia and to identify predictors of nosocomial pneumonia in critically ill trauma patients.

Adult↗
PubMed1999

Women's responses to battering: a test of the model.

A volunteer community sample of 141 well-educated, economically heterogeneous, primarily African American (80%), urban battered women was used to test a model of women's responses to battering. The model, based on Orem's theory, was developed previously with an independent sample. The major independent variables were physical and nonphysical abuse, and self-care agency. The outcomes were physical and emotional health. Using structural equation modeling techniques, there was sufficient support for the model structure to conclude preliminary support for the overall model. There was both a direct effect of abuse on health, and an indirect effect mediated through self-care agency as a protective factor.

Adolescent↗
PubMed1997

Outcome of trauma patients after brief intervention by a substance abuse consultation service.

The Substance Abuse Consultation Service (SACS) at the University of Maryland Medical System (UMMS) conducts assessments and brief interventions for patients at the University Hospital and the Shock Trauma Center of the UMMS. This project examined a 10-week sample of trauma patients (N = 30) seen by the SACS, for whom consultations and recommendations (including participation in formal treatment programs as well as 12-step meetings) were provided. The authors used medical record reviews for background information and telephone interviews for follow-up. Of 22 subjects reached by telephone, 6 reported that they had followed the SACS recommendations completely or partially, and 16 subjects reported they had not. Of the latter group, a majority reported self-imposed abstinence or decreased use. No relationships existed between demographic characteristics or patterns of substance abuse and whether or not subjects acted upon SACS recommendations.

Adult↗
PubMed1995

Identification and referral of hospitalized patients in need of home care.

Given current concerns about the cost-effectiveness of home health care, better targeting of home health services for high risk groups is viewed as one way to provide controls on both service delivery and costs. The purpose of this exploratory study was to determine the degree to which patients with identifiable levels of need for services were referred for home health care and if selected clinical and functional status measures are useful in distinguishing need for service. Using a convenience sample of 145 patients ready for hospital discharge, data were collected on physical function, dependency at discharge, perceived helpfulness of others, social support, readiness for self-care, and planned adherence to treatment as well as demographic and medical variables. Using a combination of study variables, 93% of patients not in need of services could be correctly classified. In addition, patients in need of service but not referred by their physicians were found to differ significantly from patients not in need of care on all dimensions. Suggestions are offered for further research to determine if and what systematic factors influence referral decisions for home health care and which specific patient characteristics are associated with the most cost-effective long-term outcomes.

Female↗
PubMed1995

The growth of meta-analytic literature from 1980 to 1993.

A search of the literature was undertaken to estimate the number of meta-analytic studies that have been published in the social and health sciences to date. Altogether, 1,874 published quantitative reviews were located by the end of 1994: 892 in the health sciences, 982 in the social sciences. Trends from 1980 to 1993 indicate that, while the social sciences embraced the technique earlier, health researchers are now publishing almost twice as many meta-analyses as their social science colleagues.

Data Collection↗
PubMed1995

Realizing the meta-analytic potential--a survey of experts.

A survey of 99 authors of meta-analyses conducted between 1988 and 1993 was undertaken to identify policies and products that might be helpful in the realization of the procedure's ultimate potential. Although a number of differences were found between medical and social/nonmedically related health scientists, the greatest degree of overall enthusiasm for both groups was observed for the need to educate journal editors and primary researchers regarding information that needs to be reported in an empirical study. The respondents were also in general agreement that a consensus should be developed and disseminated on minimum standards for published meta-analyses. A number of the other proposals were less popular, although an argument is made that some of these have actually come to fruition since the original survey was conducted.

Data Collection↗
PubMed1991

The Patient Intensity for Nursing Index: a validity assessment.

The psychometric assessment of a new measure of nursing intensity, The Patient Intensity for Nursing Index (PINI) is reported. Four dimensions of nursing intensity are measured by the PINI: (a) severity of illness, (b) dependency, (c) complexity of care, and (d) time. There are 10 items rated on a 5-point ordinal scale. A purposively drawn sample of 6,445 patients was obtained from five hospitals, with 487 registered nurses (RNs) providing daily patient ratings from 29 medical-surgical and intensive care units. Substantial interrater reliability was demonstrated. Validity testing included confirmatory factor analysis, hypothesis-testing, contrasted groups, and an observational study of time. The factor structure confirmed specified components of severity, dependency, and complexity, with time loading on all three factors. PINI scores were significantly related to medical severity of illness, length of hospital stay, disposition at discharge, number of secondary medical diagnoses and specialty consults, and scores on three different hospital classification systems used for staffing. PINI scores were significantly different for high- and low-intensity DRGs. Observed time spent delivering nursing care to specific patients was significantly correlated with nurse estimates of time.

Dependency, Psychological↗
PubMed1991

Patient intensity for nursing index: the measurement model.

One part of the psychometric evaluation of the Patient Intensity for Nursing Index (PINI), a new measure of nursing intensity, is reported. The PINI has four interrelated components: (a) severity of illness, (b) dependency, (c) complexity of care, and (d) time. Taken together, the 10 items that make up these four components comprise the multidimensional construct of nursing intensity. Using the factor analytic approach and a model specification search, the measurement model for the Patient Intensity for Nursing Index was identified. The structure consists of Dependency, Severity, and Complexity with time (hours of nursing care) loading on each factor. When results were cross-validated using data from four other hospitals, support emerged for a consistent pattern of factor loadings. The loadings themselves, however, are only partially invariant. Further examination of the relationship between severity and time is suggested and areas for future research are identified.

Dependency, Psychological↗
PubMed1991

Predictors of hospital readmission. A meta-analysis.

Summarizing the results of research related to identifying potential predictors of hospital readmissions has been difficult because of conflicting results across studies. Using the techniques of meta-analysis, the results from 44 studies were examined in the present study. Overall, the mean readmission rate was 27%, with significant differences based on patient diagnosis. Although diagnosis, age, initial length of hospital stay, and prior use of hospital resources were related to readmission, the strength of the relationship is trivial. Combining data from 12 intervention studies designed to reduce readmission indicated that the overall treatment effect was not significant. Further research is needed to determine demographic, clinical, and social predictors of readmission if strategies are to be developed to reduce readmission and the resulting health care costs.

Age Factors↗
PubMed1990

The process of rater training for observational instruments: implications for interrater reliability.

Although the process of rater training is important for establishing interrater reliability of observational instruments, there is little information available in current literature to guide the researcher. In this article, principles and procedures that can be used when rater performance is a critical element of reliability assessment are described. Three phases of the process of rater training are presented: (a) training raters to use the instrument; (b) evaluating rater performance at the end of training; and (c) determining the extent to which rater training is maintained during a reliability study. An example is presented to illustrate how these phases were incorporated in a study to examine the reliability of a measure of patient intensity called the Patient Intensity for Nursing Index (PINI).

Employee Performance Appraisal↗
PubMed1990

Hope and spiritual well-being: essentials for living with AIDS.

Without a cure on the horizon there is a need to identify ways to sustain hope and spiritual well-being in patients with AIDS. This article examines the impact of AIDS on the emotional and spiritual health of its victims and summarizes current research findings on spiritual well-being in the ill. It also summarizes the authors' study on hope and existential and spiritual well-being in a group of 65 adult male patients who were either serum positive for the human immunodeficient virus or who had been diagnosed with AIDS Related Complex or AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Alcohol use and its relationship to other addictive and preventive behaviors.

Immoderate consumption of alcohol was found to be related to three other potentially addictive behaviors (illicit drug use, smoking, and caffeine consumption) in a randomly drawn sample (n = 1253) of American adults. In addition, alcohol consumption was found to be related to nutritional, life style, safety, and health monitoring preventive behaviors. Although the underlying mechanism for these behaviors is not clear, possibilities include the subsumption of both addictive and other preventive behaviors under a more generalized risk taking (or risk avoidance) dimension.

Adult↗
PubMed1989

Preventive behaviour: attitudes and compliance of nursing students.

As a professional, the nurse is called upon to serve as a role model for positive health behaviours. Because the practise of these behaviours may effect one's effectiveness as a role model, it is important to determine whether nurses lead a so-called preventive lifestyle and to identify what factors are predictive of compliance. Previous researchers have tended to examine individual behaviours. In this study, a prevention index was used to examine an overall preventive lifestyle. For a sample of senior year nursing students, the preventive behaviours were considered to be important. However, when compared to a national sample of females in the same age range, nursing students were found to be significantly less compliant for 12 of 19 behaviours and more compliant for only three behaviours. Both the desire to practise preventive behaviours and the perceived difficulty in doing so were the factors predictive of the level of compliance. Additional study is needed to determine how these factors can be mediated.

Adult↗