PubMed Health⌕ Search

Biomedical subjects

M K Douglas

Publications and source records attributed to M K Douglas.

9 recordsLinked to original sources
PubMed1996

The work of auxiliary nurses in Mexico: stressors, satisfiers and coping strategies.

Recruitment and retention of nursing personnel is a major problem in many parts of the world, particularly developing countries. Strategies for promoting job satisfaction can help reduce the costs of high turnover and increase the quality of patient care. As part of a larger international study on women's health, a convenience sample of 59 Mexican nursing assistants and technical nurses, categorized as auxiliary nurses, were asked to complete a questionnaire designed to elicit their perceived work-related stresses and satisfactions, as well as the coping strategies they utilized to diminish work-associated stress. Major satisfiers included self-fulfillment, providing service and working as a member of a team. Frequent stressors were interpersonal relations, "angustia" (anguish), work overload and the work environment. These auxiliary nursing personnel utilized problem-solving techniques, recreational activities, talking to family and friends and actively trying to relax themselves in order to cope with their work-related stress.

Adaptation, Psychological↗
PubMed1996

Employed Mexican women as mothers and partners: valued, empowered and overloaded.

This study was designed to explore the daily lived experiences of a group of employed, low-income Mexican women in their maternal and spousal roles. The participants were 41 auxiliary nurses recruited from two large urban hospitals in Mexico. Data were collected through the Women's Roles Interview Protocol (WRIP), which solicited the participants' perceptions of the satisfaction and stresses they experienced in their roles as mothers and spouses, and their descriptions of the coping strategies and the resources they used to deal with stressful life experiences related to these roles. Data analysis consisted of a qualitative thematic analysis of the narrative responses to open-ended questions in the WRIP. Satisfying aspects of the maternal and spousal roles, as identified by the participants, included giving to and receiving from their children and being valued and supported by their partners. Spousal approval of their work was also satisfying. These employed mothers, however, experienced many stressful aspects of functioning in multiple roles, including lack of resources, being absent from their children, self-doubt about their maternal role functioning, role overload and spousal absences. The women coped by juggling priorities and utilizing family resources. From the data analysis, the investigators developed a conceptual framework for understanding these women's experiences with parenting and marriage. The centrality of the family, a sense of value and empowerment as women in maternal and spousal roles, and the reality of role overload are discussed within the Mexican culture context of machismo, its female counterpart hembrismo, and family life. Implications for women's health are framed within a context of family and work.

Adaptation, Psychological↗
PubMed1996

Differentiation between dyspnea and its affective components.

This study investigated whether people with chronic obstructive pulmonary disease (COPD) can differentiate distress and anxiety associated with dyspnea from the intensity of dyspnea and the perceived effort of breathing. Fifty-two subjects with COPD rated their perception of the individual components of dyspnea on a 200 mm visual analog scale at rest, after a 6-min walk (6MD), and every 2 min during an incremental treadmill test (ET). Subjects differentiated among the four dyspnea components at the end of the 6MD (p < .0001) and during ET (at rest, p < 0.001; at 75% VO2 max, p < 0.0001; and at end exercise, p < 0.0001). Intensity was significantly related to perceived effort of breathing (p < .0001), as distress was to anxiety (p < .0001), suggesting that each pair measures similar components. Subjects were able to differentiate their affective response to dyspnea from the intensity of the symptom. Measurement of a patient's affective response to dyspnea may improve the selection of specific treatments and validity of outcomes.

Aged↗
PubMed1996

Exercise training decreases dyspnea and the distress and anxiety associated with it. Monitoring alone may be as effective as coaching.

STUDY OBJECTIVE: To determine whether exercise training with coaching is more effective than exercise training alone in reducing dyspnea and the anxiety and distress associated with it and improving exercise performance, self-efficacy for walking, and dyspnea with activities of daily living. DESIGN: Randomized clinical trial of 51 dyspnea-limited patients with COPD assigned to monitored (n = 27) or coached (n = 24) exercise groups. SETTING: Outpatient area of university teaching hospital. INTERVENTION: Both groups completed 12 supervised treadmill training sessions (phase 1) over 4 weeks followed by 8 weeks of home walking (phase 2). The CE group also received coaching during training. MEASUREMENTS: Perceived work of breathing, dyspnea intensity, distress associated with dyspnea, and anxiety associated with dyspnea were rated on a visual analog scale during incremental treadmill testing and after 6-min walks before and after phase 1. Dyspnea with activities of daily living, self-efficacy for walking, state anxiety, and 6-min walks were measured before and after both phases. RESULTS: Dyspnea and the associated distress and anxiety improved significantly for both groups relative to work performed and in relation to ventilation (p < 0.05). There were no significant differences between groups in any outcomes. The phase 1 improvement in laboratory dyspnea was accompanied by improvements in dyspnea with activities of daily living (p < 0.01) and self-efficacy for home walking (p < 0.01) that were sustained during the home phase. CONCLUSIONS: Coaching with exercise training was no more effective than exercise training alone in improving exercise performance, dyspnea, and the anxiety and distress associated with it, dyspnea with activities, and self-efficacy for walking.

Aged↗
PubMedDate not supplied

Auxiliary nurses in Mexico: impact of multiple roles on their health.

As more women worldwide enter the labor force, debate has been generated over how this additional work role influences women's health. In this study, we explored the work, maternal, and spousal roles of 59 auxiliary nurses in two university-affiliated Mexican hospitals. Participants completed questionnaires that included demographics, a women's roles interview protocol, a self-rating of health status, and the Cornell Medical Index (CMI). No significant correlation was found between the perception of their health status and the number of roles, amount of role involvement, or their perceived levels of stress and satisfaction in any of their three roles. Work stress was significantly correlated with the number of physical symptoms (r = .30, p < .05), longer periods of standing (r = .31, p < .05), more muscle strain (r = .53, p < .01), eye problems (r = .43, p < .01), frequent changes in environmental temperature (r = .30, p < .05), and perceptions of economic inadequacy (r = .37, p < .01). Years of education was not related to any health measure or degree of stress or satisfaction in any of the roles. The greater the degree of role integration, that is, the greater the sum of satisfactions minus stresses of each role, the fewer the physical symptoms (r = .48, p < .05) and the fewer total symptoms (r = .43, p < .05) reported on the CMI. Those with more spousal stress reported more work-related muscle strain (r = .35, p < .05), and working mothers with three or more children tended to perceive themselves as less healthy (r = .75, p < .01). Thus, analyzing the interrelationship of women's multiple roles is a better predictor of health than examining specific role stresses in isolation.

Adult↗
PubMedDate not supplied

Desensitization and guided mastery: treatment approaches for the management of dyspnea.

Dyspnea is a frequent and distressing symptom for people with cardiopulmonary disease. Activity tolerance with presumably less dyspnea has been shown to increase after patients have been exposed to higher than usual dyspnea in a safe, monitored environment. Authors have suggested this decrease in dyspnea with activity may be due to a process of "desensitization" to the anxiety associated with the shortness of breath. The use of desensitization for other symptoms and phobias has evolved over time from an exposure-anxiety approach to a coping-mastery paradigm, labeled by some as guided mastery. This article reviews selected research studies that have used desensitization and guided mastery to treat other symptoms and phobias. Components of these two approaches are described and clinical strategies incorporating the two techniques with pulmonary patients during exercise-induced dyspnea are presented. A conceptual model that relates the two treatment approaches to the perception of the symptom and health outcomes is proposed.

Adaptation, Psychological↗
PubMedDate not supplied

Prioritizing competencies: increasing nurse satisfaction with competency testing.

During this period of low patient census, downsizing, and reorganization, nurses already complain they do not feel respected. Expanding competency evaluations only adds to this feeling that others do not respect the professional nurse. These authors describe strategies to use with a competency fair that decrease this feeling that nurses are being "checked on" and increase nurse satisfaction.

Clinical Competence↗