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Biomedical subjects

M Chamberlain

Publications and source records attributed to M Chamberlain.

78 records · Page 5Linked to original sources

Pediatric intensive care nurses and their grief experiences: a phenomenological study.

OBJECTIVE: To describe the grief experience of pediatric intensive care nurses when their patients die. DESIGN: Heideggerian phenomenological approach; nonprobability, purposive sampling; semistructured interviews; data analyzed using Colaizzi's method of phenomenology. SETTING: Pediatric intensive care unit within a Canadian pediatric metropolitan university teaching hospital. PARTICIPANTS: Six registered nurses, currently working in the pediatric intensive care unit, who had experienced the death of at least three children for whom they had cared. Nursing experience ranged from 2 to 20 years, intensive care nursing experience from 9 months to 19 years, and tenure on the unit from 9 months to 15 years. RESULTS: Data were analyzed for recurring themes according to the procedure outlined by Colaizzi. These nurses acknowledged they suffered multiple exposures to children's death and experienced grief. The interviews revealed eight themes that included one about their grief responses--hurting; two that described the influencing contextual factors--nurse-family unit relationship and dissonance; and five that related to coping strategies used to manage their feeling of grief--self-expression, self-nurturance, termination of relationship activities, engaging in control-taking activities, and self-reflection. Further analysis revealed that managing grief effectively was an experiential learning process for the participants. CONCLUSIONS: These results demonstrate that pediatric intensive care nurses' grief is different from that of surviving family member grief. Further research is required to document in further depth the experiential learning process to coping with multiple, accumulated losses for these professional caregivers. The findings of this study also could encourage further research that examines interventions designed to enhance the type of education and support needed in relation to the grief experience of nurses.

Adaptation, Psychological↗

Measuring nursing support during childbirth.

PURPOSE: To examine the amount of support being provided by nurses to women during childbirth and factors that influence the provision of support. STUDY DESIGN: Exploratory, descriptive. METHODS: Work sampling method was used to determine the percentage of time nurses spend in supportive care activities. Twelve nurses were observed over six nonconsecutive day shifts on a birthing unit of a Canadian teaching hospital in Quebec. A total of 404 observations were made. Nurses were also interviewed to determine their perceptions of what constitutes supportive nursing care and the factors that facilitate or inhibit the provision of this care. RESULTS: Nurses spent only 12.4% of their total time providing supportive care to laboring women. Interviews with nurses suggested that perceptions of the components of supportive care were comparable to this study's operational definition of support, namely: physical, emotional, and instructional/informational support and advocacy. Barriers to providing support identified by nurses included lack of time and insufficient staff. However, further content analysis of the interview data revealed that healthcare providers had a pervasive sense of control over laboring women and their partners. CLINICAL IMPLICATIONS: Although nursing support has been identified as an important aspect of nursing care in childbirth, this study demonstrated an incongruity between what nurses perceived as being supportive care and the amount of support that was actually provided. Barriers to the provision of supportive care in the practice setting as well as suggestions for its enhancement are discussed.

Female↗

National survey of radionuclide gastric emptying studies.

A survey was mailed to all institutions in Canada licensed to use radiopharmaceuticals. Questions addressed meal type; mode of preparation; and means, ranges and SD of emptying times. Seventy-eight per cent of 222 facilities responded, including all 55 teaching centres. Eighty-five per cent of teaching and 56% of nonteaching centres perform solid phase gastric emptying studies (GES). The majority use 99mTc sulphur colloid (Tc-SC) added to eggs before cooking as the standard meal. Twenty-five per cent of teaching and 21% of nonteaching centres perform liquid phase GES. Most use a watery solution of 111Indiethylenetriamine pentaacetic acid. Gastric emptying for solid phase GES, expressed as time for 50% emptying (mean t1/2), varied from 42 to 105 mins for centres using the Tc-SC egg meal. Twenty-eight per cent of teaching centres used +/- 2 SD to define their normal range, 26% used +/- 1 SD, 6% used +/- 1.5 SD, and 40% did not know the number of SD used. Twenty per cent of nonteaching centres used +/- 2 SD, 12% used +/- 1 SD and 68% did not know how many SD were used. For liquid phase GES, mean t1/2 varied from 20 to 60 mins. Eighteen per cent of centres used healthy volunteers to establish or validate normal ranges. There is substantial variability among the normal ranges for radionuclide solid and liquid phase GES in both teaching and nonteaching centres across Canada. A minority of facilities have established or validated their own normal ranges in healthy volunteers. There is a need for a more standardized protocol and range of normal, with internal validation by each institution.

Canada↗

Induction of molecular remission by donor peripheral blood leukocyte therapy in patients relapsing with extramedullary blastic phase chronic myeloid leukemia after allogeneic bone marrow transplantation.

Two patients with chronic myeloid leukemia (CML) who relapsed in blastic transformation after allogeneic bone marrow transplantation (BMT) were treated with infusions of leukapheresed peripheral blood mononuclear cells from their original donor. At relapse, their disease was characterized by symptomatic extramedullary deposits of leukemia with minimal (PCR positive, cytologically negative) involvement of bone marrow. Treatment with donor cell infusions was associated with clinical remission, return of full donor chimerism and loss of the BCR-ABL transcript detectable in bone marrow before donor leukocyte infusion (molecular remission). Donor leukocyte infusions should be considered for therapy of relapsed blastic phase CML after allogeneic BMT, especially when the relapse is primarily extramedullary and responsive to local and systemic cytoreductive therapy. However, severe GVHD and CNS relapse remain obstacles to achieving a successful long-term outcome.

Adult↗

In vitro biological effects of glass fibers.

Two glass fiber samples, which had previously been tested for their ability to induce mesotheliomata in rats, were subjected to size fractionation and the respirable fibers from each were collected. The sizes of the fibers in the total and respirable fractions were measured and all four materials were tested in vitro for their cytotoxic activities against V79-4 cells, A549 cells, and mouse peritoneal macrophages. The respirable fraction from the coarser material had considerably enhanced activity (on a mass basis) compared with its parent (total) material. The respirable fraction of the other fiber was only slightly more active than the corresponding total sample. The fiber size distributions are discussed in relation to the observed biological activity of all four samples, and it is concluded that the cytotoxic activity of fibrous glass is determined by the number of fibers within certain size ranges. It is likely that in the systems used in this present paper, fibers less than 10 micrometer long are inactive. The relationship between these observations and those obtained with fibrous glass in vivo by Stanton et al. (1977) are discussed.

Animals↗

Cultural differences in Canadian-Chinese nursing.

The Schools of Nursing of Tianjin Medical College and the University of Ottawa have been partners in a Canadian-Chinese linkage project funded by the Canadian International Development Agency (CIDA) and the Chinese Government since 1989, at teh instigation of Canadian faculty member Nancy Johnson who saw the need for academic support for the Chinese nursing community.

Acupuncture Therapy↗