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Biomedical subjects

M L Lanza

Publications and source records attributed to M L Lanza.

At least 55 records · Page 3Linked to original sources
PubMed1983

The reactions of nursing staff to physical assault by a patient.

Forty nursing staff members in a Veterans Administration neuropsychiatric hospital were surveyed in a study aimed at determining victims' responses to the assault and helping to sensitize clinicians to the frequency and outcomes of assaults on nursing staff. The respondents, who had an average of six years of psychiatric nursing experience, reported being assaulted an average of seven times prior to the study period. The author summarizes the emotional, social, biophysiological, and cognitive responses of the respondents and notes that a major finding was the large number of staff who indicated they had no reactions to the assault. She speculates that staff may be unable to admit their reactions even to themselves and discusses some possible reasons for that situation.

Adaptation, Psychological↗
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Feminist leadership through total quality management.

Feminist leadership in nursing can be achieved through Total Quality Management. Total Quality Management (TQM) is a philosophy and technology that represents the foundation of a continuously improving organization. The feminist leadership ideas practiced by nurses, such as empowering staff and decision by consensus, are also central to TQM. Feminist leadership utilizing TQM enables employees to creatively contribute to the system without fear or intimidation. Employees at all levels in the organization are then empowered. The role of the feminist leader using TQM is one of facilitator rather than authority figure. Feminist leadership in nursing can spearhead the opportunity for improvement to provide high-quality, cost-effective health care in a troubled and complex economic environment.

Female↗
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Bibliotherapy and beyond.

TOPIC: Using literature and television to promote mental health. PURPOSE: To expand readers' awareness of how literature can be used therapeutically. SOURCE: The author's personal experience hosting a TV program entitled, "Best Books in Town". CONCLUSIONS: Discussing literature can promote emotional catharsis, active problem solving, and personal insight in those who chose to participate.

Bibliotherapy↗
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A multidisciplinary course to teach staff to conduct psychodynamic group psychotherapy for assaultive men.

TOPIC: A course in leading psychodynamic psychotherapy groups for assaultive men. PURPOSE: To teach multidisciplinary staff members to lead these groups, using both didactic and experiential learning. SOURCE: The author's own experience. CONCLUSIONS: Multidisciplinary staff members learned about the process of leading psychotherapy groups for assaultive men by attending lectures and observing the author lead a group over a 6-month period. The author's openness about her own thoughts, feelings, fantasies, and countertransference allowed students to explore their own reactions and to empathize with the patients, observing that they were not so different from them.

Curriculum↗
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Predicting violence: nursing diagnosis versus psychiatric diagnosis.

Predicting violent behavior is a major concern for nurses as well as other mental health professionals. Two diagnostic assessment systems (Nursing Diagnosis-NANDA and Psychiatric Diagnosis-DSM III-R) were compared in their ability to predict assaultive behavior. The nursing diagnosis potential for violence suggested a difference (p = .07) between the assaultive and control subjects. No differences were found between assaultive and control subjects on psychiatric diagnoses. Nursing diagnosis is based upon measurable behaviors and is time specific. Clinical implications and further research endeavors in this area are suggested.

Case-Control Studies↗
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Nursing staff characteristics related to patient assault.

There is an underlying belief that there is something special about the victims of patient assault, that they possess certain characteristics or behave in a different way from those staff who are not assaulted. Is this a case of blaming the victims, or are there some actual differences between those staff members who are assaulted and those who are not? This study undertook this question. Its specific purpose was to (1) characterize staff victims and compare them to nonassaulted staff and (2) document outcomes on staff who were assaulted. The design included a prospective and retrospective phase. Nursing staff on two acute and four long-term psychiatric units were asked sociodemographic and job-related information at the beginning of the study. The frequency with which each staff member was assaulted was recorded. At the end of 1 year, staff who had been assaulted were compared with staff who had not been assaulted. Any staff members who were assaulated were interviewed to assess the physical and emotional effect of the assault on the victim. Findings indicated no difference between assaulted versus nonassaulted staff on sociodemographic factors, with the exception of marital status. Assessment of job-related factors suggested differences on position in the administrative hierarchy, type of activities involved in direct patient care such as medication administration, and education about handling the aggressive patient. Victim outcomes supported the existing literature. The most frequent site of injury was the head. Staff either did not take leave time or returned to work before they recovered, and many reported emotional stress.

Hospitals, Psychiatric↗
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Environmental characteristics related to patient assault.

Environmental factors related to physical assault by patients were examined to identify clinical implications warranting further investigation and to test methodology. The concepts of ward conditions (degree of patients' illness, numbers of patients and staff) and ward climate were the focus of the study. Participants were patients and nursing staff on two acute and four long-term psychiatric units in a large neuropsychiatric hospital. Patients and staff were asked to complete the Ward Atmosphere Scale to assess ward mood and climate. Each assault incident was identified from the daily nursing ward report. With each assault occurrence, the nurse manager was asked to complete a questionnaire about environmental conditions at the time of the assault. Most assaults occurred during meal times and afternoons. The most frequent locations were ward corridors and dayrooms. There appeared to be an inverse relationship between assault frequency and number of staff. Crowding rather than total number of patients per ward was suggested as a factor related to assault. Degree of patient acuity seemed to be inversely related to assault frequency. There were suggested trends between assault frequency and a low score on autonomy and a high score on staff control. Clinical implications, ideas for further research, and improved design measures are suggested. The challenge to understand and control this complex phenomenon remains a critical issue for inpatient nursing care.

Affect↗
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Patient assault: a comparison of patient and staff perceptions.

The purpose of this study was to compare the perceptions of assaultive patients and staff victims regarding assault incidents. The hypotheses were as follows: (1) There will be congruence between patients' and victims' reports of objective or factual information regarding the assaults and (2) there will not be congruence between patients' and victims' reports of subjective information about the assaults. Monahan's (1981) framework was used for assessing violence on the assaultive patient and the assaulted staff member. Patients who assaulted a nursing staff member and nursing staff members who were assaulted were interviewed, and the congruence of responses between each pair (patient and staff member) on each question was assessed. For 10 items designated as objective, there was agreement between patients and victims in 6 cases and disagreement in 4 cases. For 8 subjective items, in all cases patients and victims gave different perceptions.

Attitude of Health Personnel↗
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Developing psychodynamic group treatment methods for aggressive male inpatients.

Group psychotherapy is one intervention that can be used for aggressive male inpatients. This paper reports relevant literature and clinical applications for conducting a psychodynamic psychotherapy group designed to help patients (a) identify, understand, and deal with underlying problems resulting in aggressive behavior; (b) improve interpersonal relationships; and (c) find more appropriate ways of expressing feelings, particularly those associated with aggressive behavior. The review of literature focuses on therapeutic approaches for dealing with aggressive feelings in group therapy; men's issues in group psychotherapy, including stages of group development for men and the expression of aggression; and the outcome of aggressive behavior in response to group therapy. Clinical applications discussed are preparation for the group; the group contract, including the "group as a whole" approach; patient selection; modeling authority; and countertransference and projective identification.

Adaptation, Psychological↗
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Power and leadership in psychiatric nursing. Directions for the next century: Part I.

TOPIC: Power and leadership in psychiatric nursing. PURPOSE: To describe power, leadership, and their relationship to psychiatric nursing, with suggestions for the future of the discipline. SOURCE: Review of literature and author's observations of the discipline. CONCLUSIONS: The relationship of power and leadership focuses on leader qualities, a model for the interrelationship of leaders and colleagues, and the leader's achievement of a power position.

Forecasting↗