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Biomedical subjects

M Gulanick

Publications and source records attributed to M Gulanick.

16 recordsLinked to original sources
PubMed2001

Characteristics of the trauma recidivist: an exploratory descriptive study.

INTRODUCTION: The purpose of this study was to identify characteristics and perceptions of trauma recidivists. Information obtained from this study will help health care professionals better understand trauma patients and design more effective trauma prevention programs. METHODS: An exploratory descriptive, correlational design was used. A convenience sample of 100 trauma patients entering a midwestern university medical center were studied. A demographic chart review and a personal interview consisting of 29 questions were conducted for each subject. The interview questions sought information regarding high-risk behavior, risk-taking personality traits, safety precautions used, and social, psychological, and environmental factors surrounding the patient's traumatic event. RESULTS: Thirty-six percent of trauma patients studied were recidivists. The recidivist was more likely to be male, younger than 45 years, a member of a racial minority, single, uninsured, and have less than 12 years of education. Behavioral characteristics common to most recidivists included a history of past arrests, illegal drug use, and having witnessed past violent injuries. DISCUSSION: Trauma remains one of the most devastating diseases facing americans. Characteristics of trauma recidivists have been identified, and further research is needed to test possible interventions to curb the unnecessary trauma injuries that occur every day.

Age Distribution↗
PubMed2000

Coronary risk factors: influences on the lipid profile.

Risk factors for cardiovascular disease have been defined by various groups and experts for decades. Unfortunately, the lack of consensus among these groups and the periodic changes in risk factor listings have led to confusion among health care professionals. Because so many risk factors inter-relate, it is difficult to isolate the effect of a specific risk factor on the lipid profile. In an effort to eliminate some of the confusion, this article describes the known effects of physical inactivity, obesity, cigarette smoking, age, hypertension, and diabetes mellitus on lipids and lipoproteins. A summary of the known results is displayed in a table. Because of the complexity of the atherosclerotic disease process and the multifactorial influences on lipid metabolism, this remains an exciting and challenging area for research.

Age Factors↗
PubMed2000

Perimenopause and the quality of life.

The purposes of this study are to describe the frequency and distress of symptoms associated with perimenopause, to examine the changes in the quality of life (QOL) related to perimenopause, and to examine the relationships between symptoms associated with perimenopause and the QOL. A cross-sectional, correlational design was employed. Two hundred fourteen perimenopausal women completed the Women's Health Assessment Scale (WHAS) and the Quality of Life Scale. It was found that vasomotor symptoms were not central to the list of symptoms associated with perimenopause. More women reported psychosomatic complaints as opposed to vasomotor complaints. Compared to the premenopausal period, women during perimenopause experienced slightly, yet significantly decreased, levels of QOL. Multiple regression analysis demonstrated that the psychosomatic symptom category was the sole predictor of the QOL during perimenopause. In summary, psychosomatic symptoms occur most frequently and are most distressful for perimenopausal women in this study. It may be important to manage psychosomatic symptoms to improve the QOL for perimenopausal women.

Adult↗
PubMed1997

Patients' responses to the angioplasty experience: a qualitative study.

BACKGROUND: The number of coronary angioplasty procedures performed has increased more than tenfold in the past decade. Most research to date has focused on efficacy of the procedure, quality-of-life issues, and measures to promote comfort after percutaneous transluminal coronary angioplasty. Little or no research has examined the patient's experience during angioplasty. OBJECTIVE: The purpose of this study was to describe the angioplasty experience from the patient's unique perspective. METHOD: Focus-group interviews were used as the qualitative method for data collection. The sample consisted of 45 patients (26 male, 19 female) who had undergone percutaneous transluminal coronary angioplasty 3 to 18 months before the interviews. Seven focus groups (with four to nine subjects each) were conducted. Each 2-hour interview was tape recorded. Data were analyzed by using a constant comparative method. RESULTS: A wide range of themes emerged from the data. Positive themes included the following: contentment with comfort measures, satisfaction with supportive hospital care, and trust in medical competence. Negative themes included anger over unmet needs for comfort or support, feeling dehumanized, and frustration with lack of control in decision making. CONCLUSIONS: This study uncovered a broad range of experiences among patients undergoing percutaneous transluminal coronary angioplasty. Although most participants described very positive experiences, many patients expressed bitter dissatisfaction regarding several aspects of their care. Healthcare providers must be aware of these possible reactions so that they can anticipate, recognize, and intervene early and appropriately.

Adult↗
PubMed1997

Focus groups: an exciting approach to clinical nursing research.

The focus group interview is an exciting qualitative research design that is gaining popularity among nurse clinicians and researchers. This article provides a practical approach to designing and implementing focus groups. The authors' own research experience with post-coronary angioplasty patients is used as a model.

Adult↗
PubMed1997

Health practices of critical care nurses: are these nurses good role models for patients?

BACKGROUND: Few studies have explored the health practices of critical care nurses. Critical care nurses routinely teach patients about using healthy practices such as low-fat diets, exercise, and routine screening examinations. However, it may be even more important that the nurses themselves have a healthy lifestyle, thus serving as role models for patients. Nurses are selling a product, and that product is health. The best salespersons are those who are genuinely committed to their product and model its benefits. Therefore, critical care nurses' healthful practices can have a profound effect on their patients. OBJECTIVES: The purpose of this descriptive exploratory study was to examine critical care nurses' responses to three questions about health practices in their daily lives: (1) What are critical care nurses doing currently to stay healthy? (2) Do they anticipate making any changes in their lifestyle in the future? (3) Would they recommend their lifestyle to their patients? METHODS: One hundred twenty-seven critical care nurses attending a midwestern critical care conference completed a two-part questionnaire designed to produce a health profile. In a man-on-the-street approach, 23 nurses participated in an interview via video camera. Descriptive statistics were used to analyze the data retrieved from the questionnaires. Interviews were transcribed verbatim and analyzed for themes with a constant comparative method. RESULTS: More than 70% of the critical care nurses who responded engage in exercise and follow a healthy, low-fat diet. Seventy-one percent said that they anticipate making a change in their lifestyle in the future, and 70% said that they would recommend their lifestyle to their patients. Five themes emerged from the videotaped interviews: (1) Heart-healthy practices predominated the responses. (2) Incorporating a healthy lifestyle was easy for some and a struggle for others. (3) Critical care nurses readily listed barriers to healthy living. (4) The nurses had a positive attitude about their healthy lifestyles and felt optimistic about being role models for their patients. (5) Future plans were either singular in focus or limited to maintenance of current health habits. CONCLUSIONS: The majority of the nurses reported practicing a healthy lifestyle and thought that they were good role models for patients.

Adult↗
PubMed1996

Telephone nursing in a general medicine ambulatory clinic.

An innovative telephone nursing service was designed to improve care delivery and efficiency in a general medicine clinic. Professional nurses provide general health information and clinical updates and follow intervention guidelines. Patients, physicians, and nurses report high satisfaction and improved patient outcomes.

Aged↗
PubMed1994

Patients' reactions to angioplasty: realistic or not?

BACKGROUND: A major problem limiting the success of angioplasty is the high restenosis rate. In addition, coronary artery disease is an ongoing process requiring lifestyle changes to prevent disease progression. OBJECTIVE: To examine patient concerns and risk factor modification behaviors during early recovery from angioplasty. Specific attention was directed to: (1) expectation of restenosis, (2) occurrence of angina, (3) achievement of expected benefits, (4) tension/anxiety levels, (5) self-efficacy for and actual performance of needed lifestyle changes. METHODS: For this descriptive study the Self-Report of Recovery (a project-derived questionnaire) and the Profile of Mood States were mailed to 54 patients at 1, 6, and 12 weeks of recovery. The study group comprised 37 men and 17 women (mean age, 57 years) who had undergone first-time successful angioplasty at a midwestern medical center. At 12 weeks 78% remained. RESULTS: A majority of patients did not expect restenosis to occur. At 3 months 83% reported that they were angina-free, 90% reported that they would repeat the procedure if needed, all scores on the tension/anxiety scale were normal, and 86% had achieved some benefits they had expected. Most expressed high confidence in their ability to reduce risk factors, with 90% reporting initiation of at least one lifestyle change. CONCLUSION: We concluded that patients had positive feelings about their angioplasty experience and were not overly concerned about restenosis.

Adult↗
PubMed1991

Is phase 2 cardiac rehabilitation necessary for early recovery of patients with cardiac disease? A randomized, controlled study.

In this study the effects of rehabilitation teaching plus exercise testing on perceived self-efficacy for and performance of daily activities were compared with and without exercise training. Subjects were patients who had had myocardial infarction or cardiac surgery (mean age 57.7 +/- 11.3 years) and who had already received inpatient rehabilitation services. Subjects were randomly assigned to one of three groups. Treatment group 1 (n = 11) received teaching, treadmill exercise testing, and exercise training (three times weekly for 5 weeks). Treatment group 2 (n = 15) received only teaching and exercise testing. The control group (n = 14) received only routine care without supervised exercise or teaching. Measurements of self-efficacy and activity performance were made at hospital discharge and at 4 and 9 weeks after the cardiac event. Repeated-measures analysis of variance showed an increase in self-efficacy scores (p less than 0.001) and performance of physical activity (p less than 0.001) for all groups. Both treatment groups, especially the training group, obtained the highest scores, but differences between groups were nonsignificant (p greater than 0.05). These results indicate that in a sample of uncomplicated, motivated patients who had participated in a phase 1 inpatient rehabilitation program, substantial improvements in self-efficacy and performance of daily activities were made early in recovery, before the onset of phase 2, formalized outpatient therapy.

Activities of Daily Living↗
PubMedDate not supplied

Recovery patterns and lifestyle changes after coronary angioplasty: the patient's perspective.

BACKGROUND: Progression of coronary atherosclerosis remains a significant problem after percutaneous transluminal coronary angioplasty (PTCA), requiring patients to make ongoing modifications in their coronary risk factors and lifestyle. OBJECTIVE: To examine patients' reactions to suggested lifestyle changes, to identify barriers and facilitators to risk reduction, to identify sources of health information, and to elicit suggestions for nursing interventions to aid in long-term recovery. DESIGN: Qualitative study using 2-hour, tape-recorded focus group sessions. Participants were enrolled in one of seven groups (4 to 9 members each). SAMPLE: Forty-five patients (26 men, 19 women) who had undergone PTCA 3 to 18 months earlier were recruited from a university-affiliated midwestern medical center. RESULTS: Using a constant-comparative method for data analysis, six major themes emerged. Positive themes included seeking control from successful changes made; compromise with medical recommendations to maintain quality of life; and acceptance of the uncertain nature of their disease. Negative themes included powerlessness to stop disease progression; frustration with enacting lifestyle changes; and concerns about the uncertainty of the future. Specific barriers and facilitators for risk reduction were readily identified. Though patients had few suggestions for nursing interventions, the most predominant requests were for newsletters, "hot lines," and a video library. CONCLUSION: These results provide insight into the experiences of the relatively understudied PTCA population. Patients were making at least some of their necessary lifestyle changes, though often with some difficulty. Nurses have an excellent opportunity to expand their focus and provide guidance and support to patients as they adopt a heart-healthy lifestyle.

Adult↗
PubMedDate not supplied

Perimenopause: the transition into menopause.

With an ever-accumulating body of knowledge about menopause has come the realization that the transition into menopause, specifically the perimenopausal period, is a process occurring over a period of years. We now know that the majority of women do not move from a time of regular menses to an abrupt cessation of menses. Rather, they experience perimenopause, a time of menstrual irregularity defined by changes in the length of the menstrual cycle and/or changes in level of discomfort associated with menses. We also know now that hormonal levels during the perimenopausal period may fluctuate more intensely, precipitating vasomotor and other symptoms. There is a tremendous need to educate women and their health care providers about the stages of the menopausal process. Such education will foster understanding of when women can expect the onset of perimenopausal symptoms. Health care providers should assist women with their questions and concerns as they move through this time of transition.

Adult↗
PubMedDate not supplied

The relationship between physical activity and perimenopause.

Our purpose in conducting this study was to examine the relationship between physical activity and symptoms associated with perimenopause. A group of 214 perimenopausal women aged 40-55 years (mean = 47 years) completed the Women's Health Assessment Scale (assesses symptoms associated with perimenopause: vasomotor, psychosomatic, menstrual, and sexual symptoms) and the physical activity questionnaire. These women were categorized into three groups based on their levels of physical activity: inactive, relatively active, and active. Analyses of covariance (ANCOVA) revealed significant differences between groups in frequency and distress of overall symptoms associated with perimenopause (F = 8.86, p = .00, F = 6.25, p = .00, respectively). Further analyses indicated that relatively active and active women had significantly fewer and less distressful psychosomatic symptoms (F = 8.05, p = .00, F = 5.80, p = .00, respectively), such as irritability, forgetfulness, and headache as well as fewer and less distressful sexual symptoms (F = 3.42, p = .03, F = 3.73, p = .03, respectively), such as vaginal dryness and decreased sexual desire than inactive women. No significant differences were found among groups on vasomotor and menstrual symptoms. In conclusion, physical activity may be an important alternative/adjunct to hormone therapy particularly for psychosomatic and sexual symptom management at perimenopause.

Adaptation, Psychological↗
PubMedDate not supplied

Resumption of home activities following cardiac events.

Patients resume home activities at different paces after uncomplicated cardiac events, and respond to education in a variety of ways. Forty patients recovering from either myocardial infarction (MI) and coronary artery bypass surgery, or MI with coronary angioplasty who were enrolled in a randomized clinical study were interviewed and completed questionnaires regarding their experience resuming home activities. Responses indicated that uncomplicated patients can easily resume those activities important to them. Based on these findings, a Home Activity Assessment Tool was finalized to provide the practicing nurse with practical ways to guide discharge teaching. Use of this tool may facilitate patient's resumption of home, social and work activities.

Activities of Daily Living↗
PubMedDate not supplied

Barriers to the use of nursing diagnosis language in clinical settings.

Ongoing evaluation of the use of nursing diagnoses at the clinical level is critical to the facilitation of further development and refinement of the language of nursing. Therefore, the purpose of this study was to identify the status of utilization of nursing diagnosis in Illinois. A survey instrument was mailed to 239 Illinois hospitals 139 (58%) responded. Results included: 78% of the responding hospitals had implemented nursing diagnosis, with almost all (95%) utilizing NANDA terminology. Components of continuing education efforts related to nursing diagnosis were identified by 75% of the hospitals. Ongoing monitoring of quality improvement methods was reported by 45% of the respondents. The barriers to implementation cited most frequently included: limited ongoing education, lack of motivation to learn, or nurses' difficulties in adjusting to its use.

Health Knowledge, Attitudes, Practice↗