Biomedical subjects

Margaret Faut-Callahan

Publications and source records attributed to Margaret Faut-Callahan.

5 recordsLinked to original sources

PubMed2004

Sex differences in responses to epidural steroid injection for low back pain.

UNLABELLED: Sex differences in clinical and experimental pain responses have been widely reported; however, few studies have examined sex differences in outcomes from interventional pain treatment and the predictors thereof. The aims of this study were to examine sex differences in (1) the acute pain produced by epidural steroid injections (ESIs), (2) clinical improvements in pain and pain-related psychological distress and disability after ESIs, and (3) predictors of the clinical response to ESIs. A total of 57 patients (37 menopausal women and 20 men), seen in the pain clinic of a regional medical center for ESI therapy, participated. Patients rated the painfulness of the ESI procedure itself. Also, clinical pain, depression, and disability were assessed before treatment and at 2 weeks and 2 months after the ESIs. Participants also were queried about their expectations of successful pain relief, coping strategies, and pain-related anxiety, which were examined as predictors of treatment outcome. Men reported significantly greater pain intensity and unpleasantness than women for the first injection only. All groups showed significant reductions in clinical pain, depression, and disability at 2 weeks compared to baseline, but minimal change occurred between 2 weeks and 2 months past baseline. No sex differences in the magnitude of treatment response emerged; however, specific dimensions of pain coping were associated with treatment responses in a sex-dependent manner. These findings suggest that the determinants of ESI pain and treatment outcome might differ across sex. PERSPECTIVE: Sex-related influences on pain responses have been widely reported, but few studies have explored sex-dependent predictors of treatment response. These findings indicate that pain coping was differentially associated with outcomes after ESI in women versus men.

Adaptation, Psychological↗

PubMed2003

An evaluation of clinical tools to measure pain in older people with cognitive impairment.

Pain in older people with cognitive impairment is often untreated or under-treated despite the fact that the likelihood of having pain increases with advanced age. One reason that pain is poorly managed in older people is that it is not detected. Assessing pain is an integral part of clinical practice and is required for effective pain management. However, systematically measuring pain intensity and location with standardized tools in older people has not been well studied. This article will summarize tools used to assess pain in older people, inducing self-report scales measuring pain intensity, the presence or absence of pain, pain location and pain behaviour scales. Identifying the advantages and disadvantages of these clinical assessment tools has implications for nursing practice, research and education.

Aged↗

PubMed2003

What role should education standards play in the manpower shortage?

Any assertions that COA did not respond to concerns raised is not an accurate portrayal of the process and does not acknowledge the significant work the COA and the AANA Education Committee did to write standards that are relevant for nurse anesthesia education today. The COA asserts that information taken from the final draft of the standards presented in 2000 based on "a nonscientific online poll" does more to damage the credibility of COA, AANA, and the profession than it does to establish constructive dialogue. Reporting only a portion of the process used to revise the standards is inaccurate at best. This lack of scientific rigor, as appropriately acknowledged in the "Guest Editorial," offers many problems in subsequent assertions made by the authors. The COA will proceed with the established process for a major revision of the educational standards as last published. The evaluation period for COA Trial Standards continues through November 15, 2003, and COA looks forward to continued, constructive dialogue with the community of interest.

Accreditation↗

PubMed2002

Collaborative practice in advanced practice nursing in acute care.

APN in the United States encompasses a variety of collaborative models of care. Collaborative relationships with other disciplines such as medicine, pharmacy, social service, and physical, respiratory, and occupational therapy are an important component of the APN role. The collaborative relationship of the APN and physician is a unique one for providing optimal patient and family care. As changes in healthcare in acute care settings continue to occur, additional collaborative models for APN and physician care will only continue to help in meeting the healthcare needs of patients.

Cooperative Behavior↗

PubMed2002

A study of clinical decision making by certified registered nurse anesthetists.

Anesthesia outcomes and related risk factors have been studied for more than 100 years. Varying sample sizes and research methods have been used, with research findings that were open to multiple interpretations. Research with closed malpractice claims demonstrates that American Society of Anesthesiologists physical status II patients undergoing elective procedures are most likely to experience damaging events intraoperatively with resultant postoperative adverse outcomes. The process of care, including clinical decision making, contributes to adverse outcomes. Clinical decision making can be difficult to assess and measure. In this study, the cognitive psychology framework of information-processing theory and literature pertaining to the use of heuristics, or rules of thumb, and clinical biases, were used to analyze cases from the AANA Foundation closed malpractice claims database. This database contains more than 300 files involving St Paul Fire and Marine Insurance Company-covered CRNAs from across the United States. These files were analyzed by 10 CRNA investigators on the AANA Closed Claims research team. Variables such as inadequate preinduction activities, e.g., incomplete preanesthetic assessments, and use of cognitive biases and inaccurate probability estimation were associated with adverse outcomes in this research sample. Teaching of decision science in basic and continuing nurse anesthesia education is advocated.

Anesthetics↗