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Biomedical subjects

K M Donohoe

Publications and source records attributed to K M Donohoe.

11 recordsLinked to original sources
PubMed1997

The measurement of ambulatory impairment in multiple sclerosis.

The objective of this study was to examine the relationships between continuous measures of ambulatory impairment in MS patients and their ordinal counterparts. Much of the disability caused by MS is due to ambulatory impairment. The Expanded Disability Severity Scale (EDSS) and the Ambulation Index (AI) are ordinal measures of MS severity based largely on the maximal distance subjects can walk (Dmax) and the time to walk 8 m (T8), respectively. At EDSS levels 6.0 to 7.0 and AI levels 3 to 6, scores are defined more by the use of ambulatory aids, rather than by Dmax or T8. We determined Dmax (up to 500 m), T8, the EDSS score, and the AI in 237 ambulatory MS patients. The maximal distance subjects could walk and T8 were strongly related to their ordinal counterparts (Spearman r = 0.65 and 0.91, respectively), but the continuous measures showed considerable variability within EDSS and AI levels that the ordinal scales did not reflect. Most of the variability occurred at EDSS levels 6.0 to 7.0 and AI levels 3 to 6. Because the use of an aid did not clearly predict Dmax or T8, many patients in these ranges had better ambulatory function based on the continuous measures than those with less disability according to the ordinal scales. We found that Dmax and T8 provide more precise information about ambulatory impairment in MS than do the EDSS and AI, allowing better discrimination of differences between patients and potentially greater sensitivity to detect therapeutic effects in clinical trials.

Adult↗
PubMed1996

Are alternative long-term-care programs needed for adults with chronic progressive disability?

Long-term care planning for middle-aged adults with progressive neurological impairment is a largely unexplored area. The purpose of this study was to examine factors that place individuals with progressive disability at risk for institutional placement and identify whether innovative long-term care preferences would be used if available. The sample of 102 clients with a diagnosis of multiple sclerosis (N = 92) or other progressive illnesses (N = 10) was mostly female, married and Caucasian, with an average age of 48 years. The social support network of family and friends was small; most tangible aid was provided by family members. Seventy percent of the participants used community services, the most common being a home-health aide (44%) and professional nursing services (21%). Medicaid insurance, severity of functional disability and lack of social support were associated with greater use of community services. Participants could foresee using long-term care alternatives such as a community residence (65%), adult day healthcare (63%) and family respite (46%), although these services were regarded with some ambivalence. With their knowledge of community resources, nurses are in a key position to make early assessments of clients' present and future care needs and to suggest needed modifications in living arrangements to avoid premature institutionalization.

Activities of Daily Living↗
PubMed1994

Nursing care of the patient with myasthenia gravis.

Nursing priorities for patients with acquired autoimmune myasthenia gravis are reviewed. Three key aspects of care are discussed: assessment of weakness, knowledge of treatments and medications, and understanding the need for patient education and support. The article traces these needs throughout the diagnostic process, during hospitalization, including crisis, and subsequent outpatient care. Advances in treatment and their implications for nursing care are emphasized.

Humans↗
PubMed1981

Evaluation of pulmonary function in neuromuscular disease.

Pulmonary function tests were performed on 40 patients with neuromuscular disease. The maximum expiratory pressure was the most sensitive indicator of weakness and was decreased in 87% of adult patients. A comparison of Stead-Wells, electronic (Vanguard), and bellows spirometry (Vitalor) indicated an excellent correlation between the Stead-Wells and electronic devices. The bellows spirometer consistently underestimated volumes, particularly in severely weak patients.

Adolescent↗
PubMedDate not supplied

An autologous blood program coordinated by a regional blood center: a 5-year experience.

The Southern Arizona Regional Red Cross blood program offers preoperative autologous blood deposit to all patients and intraoperative autotransfusion services to all hospitals in the region. During a 5-year period, the amount of preoperatively deposited autologous blood and intraoperatively salvaged red cells available increased from 0.3 to 19.6 percent of the community's total collections. Further increases in the availability and use of autologous blood may be achieved by community-wide integration of services.

Arizona↗