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Biomedical subjects

Katherine Moore

Publications and source records attributed to Katherine Moore.

6 recordsLinked to original sources
PubMed2006

A comparison of written materials vs. materials and counselling for women with sexual dysfunction and multiple sclerosis.

AIM: Evaluate whether symptoms of vaginal dryness, low libido, less intense or delayed orgasm could be improved in women with multiple sclerosis who took part in an education or education plus counselling programme. BACKGROUND: Sexual dysfunction, a prevalent symptom in women with multiple sclerosis, can negatively affect quality-of-life. METHODS: Women attending a large multiple sclerosis clinic were invited and 62 were randomized into one of two groups. Group 1 received written materials on primary, secondary and tertiary sexual dysfunction in multiple sclerosis as well as additional resources (books, websites, list of local psychologists specializing in sexual counselling). Group 2 received the same written materials as well as three counselling sessions from the clinic nurse, the latter two by telephone. The primary outcome measures were the expanded disability status scale and the multiple sclerosis intimacy and sexuality questionnaire-19. Repeated-measures analysis of variance was used to evaluate sexual dysfunction score over time and to compare two groups. RESULTS: At baseline, total expanded disability status scale scores were not correlated with primary, secondary or tertiary sexual dysfunction. Total multiple sclerosis intimacy and sexuality questionnaire-19 score was correlated with use of anti-cholinergic medications [r (54) = 0.28, P < 0.05], but no other medications, alcohol or tobacco use. Both groups had equivalent and significant reductions in primary sexual dysfunction [F (1) = 14.79, P < 0.001] postintervention. There was a trend towards an interaction effect for tertiary sexual dysfunction [F (1) = 2.88, P = 0.096], in the direction of group 2 (education and counselling). Subjectively, women welcomed the opportunity to discuss sexual concerns and noted that the written information allowed a framework for initiating discussion with their spouses. CONCLUSION: Relatively straightforward interventions provided by a clinic nurse may help women cope with the symptoms of sexual dysfunction associated with multiple sclerosis. Women who do not benefit from basic interventions could then be referred to an expert sexual dysfunction practitioner. RELEVANCE TO CLINICAL PRACTICE: Women with multiple sclerosis experience many disease-related physical and emotional challenges of which sexuality is only one. Sensitivity to sexual dysfunction and being willing to approach the topic is appreciated by women with multiple sclerosis. Nurses do not require in-depth expertise to offer some basic suggestions which may significantly improve life quality and assist the woman with multiple sclerosis to talk about or cope with sexuality issues.

Adult↗
PubMed2005

Radical prostatectomy: men's experiences and postoperative needs.

AIMS AND OBJECTIVES: This study sought to explore men's experiences after radical prostatectomy and whether they perceived their preoperative teaching adequately prepared them for postoperative recovery. Tape-recorded telephone and face-to-face interviews were conducted at days 2, 7 and 21, and 3 and 12 months postdischarge. BACKGROUND: Although verbal and written instruction about postoperative expectations and care are provided routinely before radical prostatectomy, patients express concern about a lack of preparation in managing urinary incontinence and erectile dysfunction. DESIGN: This qualitative descriptive study explored in-depth men's experiences during the year following their surgery. METHODS: Multiple, tape-recorded, semistructured telephone interviews were conducted with 17 participants and a single, in-depth, face-to-face interview was conducted 12 months postoperatively with a subset of five men selected for their reflective and descriptive abilities. RESULTS: Although participants received comprehensive written and verbal information preoperatively, it was not sufficient to foster their management of all postoperative sequelae. Telephone follow-up, used as a data collection strategy, was helpful in fostering adjustment after surgery and relieved anxiety caused by side effects of surgery and unanswered questions. CONCLUSIONS: Pre- and postoperative teaching needs to make allowances for the impact of stress on the recall and processing of information. Written information in itself is not adequate to answer necessary questions and provide reassurance. Follow-up telephone support is recommended as a way of fostering adjustment after surgery. RELEVANCE TO CLINICAL PRACTICE: This study shows that: (i) Written information in itself is not adequate to answer necessary questions and provide reassurance, (ii) Nurses need to be prepared, both educationally and psychologically, to observe non-verbal cues and to address questions and concerns that are rarely voiced in ways that indicate their significance to the person and (iii) Men may not speak about sexuality issues in ways that accurately reflect the extent of their worry and/or distress about erectile dysfunction.

Aged↗
PubMed2004

Pad tests and self-reports of continence in men awaiting radical prostatectomy: establishing baseline norms for males.

AIMS: In this study, we report normal pad weight gain in a group self-reported continent men and compare the self-report data with the 24-hr pad test and the International Prostate Symptom Score (IPSS). MATERIALS AND METHODS: Subjects awaiting radical prostatectomy were consecutively recruited. Exclusion criteria were a previous history of urologic surgery, reported urinary incontinence, or a medical problem which could affect bladder function. RESULTS: Two hundred forty five men were enrolled. All were Caucasian, mean age 62.7 years, mean Gleason score 6.5, and mean PSA 8.3. At initial interview, all described themselves as continent of urine and 26 declined the 24-hr pad test because they were emphatic that they were continent. Of the 220 remaining, mean pad weight gain was 4.0 g on 24-hr pad test (SD 3.8; range 0-35.0 g), mean IPSS score was 7.23; 95 subjects scored > or = 8 (moderate), 13 scored > or = 20 (severe). The IPSS single Quality of Life (QOL) question and the 24 hr pad weight were not correlated; the summary IPSS score and pad weight had a correlation of 0.16 (P = 0.02) and the QOL question and the summary IPSS score had a correlation of 0.63 (P < 0.001). IPSS QOL scores were worse for those recording > or = 8 (P < 0.001). CONCLUSIONS: The range of weight gain between 0 and 35 g suggests that self-report alone of urinary continence is an inaccurate measure of continence for research purposes. We propose that a pad weight gain of 8 g or less is indicative of urinary continence in men.

Aged↗
PubMed2004

Elder care supportive interventions protocol: reducing discomfort in confused, hospitalized older adults.

This study tested the Elder Care Supportive Interventions Protocol (ECSIP), which are nursing and family support interventions designed to reduce discomfort and the associated consequences of delirium, impaired physical function, and need for post-hospital care in hospitalized older adults experiencing confusion from delirium or dementia. All adults older than age 74 or older than age 64 if from a nursing home who were admitted to the medical and surgical units of a tertiary care hospital were screened for a diagnosis of dementia, dependence on functional activities, or delirium. The ECSIP includes interventions to prevent and control discomfort, and to promote environmental organization and familiarity. Outcome measures administered within 48 to 72 hours of admission and again within 24 hours prior to discharge included the modified Discomfort Screen--Dementia Alzheimer's Type, NEECHAM Confusion Scale, and Katz Index of Activities of Daily Living. Patients problems with delirium and impaired physical function improved over hospitalization but were still pronounced at discharge. With the exception of reduced discomfort, there were no significant treatment effects for patients, which is attributed, in part, to inadequate implementation of the ECSIP protocol by nursing staff.

Aged↗