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Biomedical subjects

M C Dobratz

Publications and source records attributed to M C Dobratz.

7 recordsLinked to original sources
PubMed1995

Analysis of variables that impact psychological adaptation in home hospice patients.

In their efforts to understand the psychological impact of life-threatening illness upon individuals, researchers, for the most part, have focused on the distress associated with dying rather than the influences that promote adaptation. Early studies report relationships between the mental state of the dying and variables of age, religiosity, family relationships, and physical discomfort. This article analyzes and compares the influences of social support, pain, and age, which were confirmed in a causal model study, as direct predictors of an outcome of psychological adaptation. The data from a sample of 97 home hospice subjects is compared with other healthy, recovering ill, advanced ill, and psychiatric populations.

Adaptation, Psychological↗
PubMed1991

Pain efficacy in home hospice patients. A longitudinal study.

A descriptive, retrospective study was conducted to determine pain intensity in 30 home hospice patients identified with pain problems. Charts were reviewed, from admission to death, for numerical pain intensity ratings, changes in the route of administration, and/or changes in medication/scheduling. Patients were grouped into three categories according to their pattern of pain as follows: (a) Group I, 20 patients who had a pattern of increasing pain, a significant lowering of the pain intensity means, and frequent changes in pain management; (b) Group II, seven patients who showed little or no increase in pain; and (c) Group III, three patients who showed a decreased intake of pain medication. In contrast to Group I, both Groups II and III demonstrated few route changes, received few pain intensity ratings, and were maintained on oral medications through death. Based upon the nurses' pain intensity ratings and frequent interventions, a t test of admission and final means demonstrated a significant lowering of pain intensity, over time, for 15 patients in Group I who received consistent pain ratings.

Aged↗
PubMed1990

The Life Closure Scale: a measure of psychological adaptation in death and dying.

The Life Closure Scale (LCS) is a measure of the multidimensions of psychological adaptation during the dying process and was developed in two phases. The first phase of instrument construction was based on a retroductive method utilizing: theoretical and empirical sources, a small qualitative study and analysis of concept definitions. Three subscales identifying dimensions of psychological processes and patterns of adaptation were defined: the self-reconciled, self-restructuring, and self-closing. A corrected content validity of .83 was established by a panel of experts. The LCS scale of 45 items was devised into a 5 point Likert scale with responses from 1 (not at all) to 5 (most of the time). Phase two began a study, with 45 hospice subjects, to determine internal consistency reliability and construct validity. On preliminary testing with 20 subjects, the self-closing subscale was found to interrelate with the other two subscales. An intercorrelation of r = -.10 defined the presence of two independent subscales: the self-reconciled and the self-restructuring. Internal consistency reliability coefficients of a = .85 for the self-reconciled subscale and a = .86 for the self-restructuring subscale. Construct validity is reported for the LCS. A Pearson correlation coefficient of r = .75 was found between the LCS and the convergent measure of quality of life and an r = -.60 substantiated discriminant validity with a depression tool. Plans for tool development include further testing.

Adaptation, Psychological↗
PubMed1990

Hospice nursing. Present perspectives and future directives.

The specialty of hospice nursing calls for a highly skilled and knowledgeable practitioner. Four categories emerge to define and describe a specialist in hospice/palliative care nursing as one who practices: (a) intensive "caring"--the management of physical, psychological, social, and spiritual problems of dying persons and their families; (b) collaborative sharing--the coordinated and collaborated efforts of the extended and expanded components of hospice care services; (c) continuous knowing--the acquisition of the counseling, managing, instructing, "caring," and communicating skills/knowledge required for the specialty of hospice nursing; and (d) continuous giving--the balance of the hospice nurse's own self-care needs with the complexities and intensities of death and dying. To provide skilled, competent hospice nursing, two levels of hospice education are proposed, and descriptions are given for (a) the "hospice nurse certified (HNC)" who delivers competent, expert, and continuous patient/family care; and (c) the "hospice nurse advanced (HNA)" who provides educational needs and administers hospice care programs. Within the expanded and extended components of hospice care, the nurse works with an interdisciplinary team to provide care that is humanistic and supportive, and that is continuous and comprehensive.

Certification↗
PubMed1989

Pain in home hospice patients: an exploratory descriptive study.

A descriptive, exploratory study was conducted to determine the prevalence, severity, and relationship of pain to the physical, psychological, social, and spiritual dimensions of hospice patients. From retrospective analysis of initial treatment plans, one hundred subjects were divided into a pain (N = 58) and a non-pain (N = 42) group. Group differences were determined through percentage and chi-square analysis of observed frequencies. Findings on the prevalence, severity, and presence of pain in far-advanced cancer were consistent with those previously reported. The pain group demonstrated significant differences in number of metastatic lesions, physical limitations, alterations in elimination, and alterations in nutrition. The number of subjects completing legal and funeral arrangements was significantly higher for the pain group.

Adult↗