Biomedical subjects

Marion E Broome

Publications and source records attributed to Marion E Broome.

At least 19 recordsLinked to original sources

PubMed2006

Family patterns of decision-making in pediatric clinical trials.

The decision-making process related to a child's participation in clinical trials often involves multiple family members. The aim of this study was to compare family patterns of decision-making within and across family units in pediatric clinical trials. Participants for this secondary analysis included 14 families from a larger study of informed consent. Four distinct patterns of decision-making were identified: Exclusionary, informative, collaborative, and delegated. These patterns varied with regard to three dimensions of parents' decision-making goals, child level of involvement, and the parental role. These patterns of decision-making affect how parents and children communicate with health professionals and influence the effectiveness of health care providers interactions with the family related to the decision-making process.

Adaptation, Psychological↗

PubMed2006

Effective weight loss for overweight children: a meta-analysis of intervention studies.

Childhood overweight has increased in the United States. Success of weight-loss programs has been limited (Barlow, S.E., & Dietz, W.H. (1998). Obesity evaluation and treatment: Expert committee recomendations. Pediatrics, 102, e29.). The purpose of this investigation was to systematically examine the effectiveness of weight-loss interventions for children. For this meta-analysis, seven weight-loss intervention studies were coded and quality index scores calculated. The interventions had a significant positive effect on weight-loss average d = 0.95, with a 95% confidence interval of 0.79 to 1.11. Limited interventional studies with effective long-term maintenance of weight loss in children are available in the literature. However, there are effective methods for weight loss in children.

Adolescent↗

PubMed2006

Playing in the park: what school-age children tell us about imagery.

The purpose of this exploratory study was to describe children's use of imagery before and after ambulatory surgery (AS). The study sample was a subset of 75 children (7-12 years) who were randomly assigned to the treatment group (n = 38) from five AS settings in a larger study on the effectiveness of imagery after surgery. They listened to an audiotape of imagery before surgery, after surgery, and after discharge from AS. Imagery use was evaluated with the Imagery Assessment Questionnaire and a home diary. Imagery tapes were used significantly more times at home after surgery than before surgery. There were no significant changes in the children's Imagery Assessment Questionnaire scores at any time point. Children most often imagined going to the park when they used the tape.

Ambulatory Surgical Procedures↗

PubMed2006

Implementing the research budget.

Reworking a reduced budget after the award and monitoring and managing the budget once funds are received are critical to the success of a research project. Few resources are available to help principal investigators and research teams deal with these components of grant implementation. This article will address strategies and concerns related to the revision of the postaward budget and the implementation of the budget. Among the strategies discussed for the revision of the postaward budget are cost sharing, renegotiation with administration, and reallocation of funds. Also addressed are topics related to monitoring and managing the budget, including understanding budget guidelines, account management and documentation, tracking expenditures, and challenges in grant budget management.

Budgets↗

PubMed2005

An integrative review of interventions for adolescent weight loss.

The number of overweight adolescents aged 12-19 has tripled during the past 2 decades. Although health risks associated with obesity in adolescence and adulthood are well documented in the literature, little is known about the efficacy of interventions to reduce health risks of this group. The purpose of this study was to conduct a systematic review to describe the scope, domain, and effectiveness of weight loss interventions with overweight adolescents. English-language journal articles published in nursing, psychology, nutrition, medicine, and exercise physiology literature between 1980 and 2003 were retrieved. Seventeen studies using comparison or control groups and interventions directed at reductions in adolescent body mass index or body weight were identified. Descriptive findings of those studies are reported here. Five specific limitations of these studies emerged from the analysis of the interventions: the study findings have not been validated by replication, the samples failed to include adequate representation of Latino and African American male participants, family participation in studies has been inconsistent and infrequent, there is a need for attention to study dropout rates (with attrition reported as high as 45%), and there is a need for conceptual frameworks to guide the studies.

Adolescent↗

PubMed2004

Imagery reduces children's post-operative pain.

This un-blinded experimental study investigated the effectiveness of imagery, in addition to routine analgesics, in reducing tonsillectomy and/or adenoidectomy pain and anxiety after ambulatory surgery (AS) and at home. Seventy-three children, aged 7-12, were recruited from five AS settings. Thirty-six children randomly assigned to the treatment group watched a professionally developed videotape on the use of imagery and then listened to a 30-min audio tape of imagery approximately 1 week prior to surgery (T1). They listened to only the audio tape 1-4 h after surgery (T2), and 22-27 h after discharge from AS (T3). The 37 children in the attention-control group received standard care. Pain and anxiety were measured at each time-point in both groups. Measures of sensory pain were the Oucher and amount of analgesics used in AS and home; affective pain was measured with the Facial Affective Scale (FAS). Anxiety was measured using the State Trait Anxiety Inventory for Children (STAIC). When controlling for trait anxiety and opioid and non-opioid intake 1-4 h before the pain measures, MANCOVA showed significantly lower pain and anxiety in the treatment group at T2, but not at T3. When controlling for trait anxiety, a two-way RM MANCOVA indicated no significant group differences in combined opioid and non-opioid use between the groups, or between times. Appropriately trained health care providers should use imagery to reduce post-operative pain following tonsillectomy and/or adenoidectomy in AS. Teaching parents about adequate home administration of analgesics may increase the effectiveness of imagery at home.

Ambulatory Surgical Procedures↗

PubMed2004

Polydipsia screening tool.

Polydipsia is a condition whereby individuals consume excessive amounts of liquids, which is common in patients with schizophrenia. A 17-item Polydipsia Screening Tool (PST; Copyright 2000 by Sheila Reynolds) was evaluated for psychometric properties. Five nurses and 70 psychiatric residents in a 92-bed nursing home comprised the samples. The interrater reliability (mean intraclass correlation coefficient) was 0.84. The average test-retest agreement was 92.4% with agreement ranging from 75% to 100%. Internal consistency of the tool was 0.79. Sensitivity and specificity were 80% and 68%, respectively. Additionally, validity of the PST was supported using a medical record history of polydipsia, low serum sodium, and low specific gravity.

Drinking Behavior↗

PubMed2004

Identifying at risk nursing home residents using a polydipsia screening tool.

Persons diagnosed with schizophrenia are considered at risk for polydipsia, a potentially life-threatening condition characterized by excessive consumption of fluids. This study examined the demographic and health-related characteristics of nursing home residents with psychiatric diagnoses (N = 70) who reside in a 92-bed facility. The prevalence of polydipsia and behavioral characteristics and symptoms as measured by a 17-item polydipsia screening tool also were described. Patients who screened positive for polydipsia (36%) exhibited behaviors that included incontinence, smoking, frequent voiding, and preference for fluid over food. A polydipsia screening program could minimize morbidity and mortality associated with this fairly prevalent condition.

Adult↗

PubMed2004

Incentives for children in research.

PURPOSE: To describe the challenges of using incentives for children in research. ORGANIZING FRAMEWORK: A discussion of incentives in the context of recruitment for research, including a review of the literature, a description of the types of incentives used with children and their families, factors influencing choice of incentives and ethical considerations. Recommendations to guide decisions about incentives are proposed. CONCLUSIONS: Since the 1997 mandate from the U.S. National Institutes of Health that investigators provide justification for excluding children, researchers have become more willing to include children. Whether all parts of the research process pertain to children without careful consideration and adaptation is unclear. One area lacking clarity is the use of incentives to encourage participation in research. The issue of incentives for children or parents should be considered early in the design of the research proposal, with attention to developmental age, ethical considerations, purpose of the research, and burden to the child and family.

Adolescent↗

PubMed2003

A study of the effectiveness of a pain management education booklet for parents of children having cardiac surgery.

Parents need education about pain so they can support their hospitalized child and manage their child's pain at home. The purpose of this study was to examine the effectiveness of a pain booklet on parental pain support to children experiencing postoperative pain. A randomized, repeated measures, experimental design using a pain education booklet and a standard care comparison group was used to study parents of 51 children (3 to 16 years of age) having cardiac surgery. Measurement techniques used to assess differences in parental pain management included: attitudes about pain medication, child and parent pain ratings (Oucher), opioids used, recovery, satisfaction, and comfort in communication. Results indicate that children do report moderate levels of pain postoperatively. Parents who were exposed to the pain assessment and management for parents education booklet preoperatively significantly increased their knowledge and attitudes toward pain medication scores from pre- to post-test, whereas those in the control group remained stable. Post-test scores were not significantly different between groups. Child and parent pain ratings were significantly and positively correlated. Practice implications include the use of an educational booklet about pain with parents before surgery to increase their knowledge about and attitudes toward pain management. Additionally, a parent may provide an alternative pain report when a child is unable to or unwilling to self-report their pain.

Adolescent↗

PubMed2003

Scientific integrity--the cornerstone of knowledge.

In the past, nurses often found themselves pressured within complex social interactions in the research environment that often overshadowed their advocacy role for the patient (Davis, 1989). With the recent emphasis on enforcing adequate protections for participants in research, nurses need to feel free to act as sentient beings with a conscience and a strong commitment to their patients. It is only through this advocacy role that scientific misconduct can be reduced and research integrity upheld.

Clinical Nursing Research↗

PubMed2002

Maximizing retention in community-based clinical trials.

PURPOSE: To identify and discuss retention strategies and their effectiveness in community-based clinical trials in the last decade. METHODS: Online and hand searches for reports for the period 1990-1999. A total of 87 reports on 64 different trials were found; 21 of these published reports included a description of both retention strategies and outcomes. These studies, rank-ordered on participant retention, were compared. FINDINGS: Despite differences in study populations, interventions, and endpoints, community-based trials with the highest retention rates included a combination of retention strategies. CONCLUSIONS: As more funding agencies emphasize clinical trials, more investigators will be held accountable for credible and generalizable findings based on retaining the projected number of study participants. The small number of published reports for the decade that identified both retention strategies and outcomes substantiates the need to better document these factors in future research reports.

Clinical Trials as Topic↗

PubMed1989

Parent and child behavior during immunization.

The purpose of this study was to examine the relationship between a mother's rating of her own and her child's anxiety and their observed behavior during an immunization. Eighty-three preschool children and their mothers were observed in a health screening clinic while the child received an immunization. Each mother was asked to rate how anxious she and her child were immediately prior to the immunization. Both mother and child behaviors were observed and rated using separate 5-point behavior scales. The results of this study indicate that although child behavior during an immunization varied a great deal, most mothers reassured and very few admonished their children during the immunization procedure. Children with extremely reassuring parents fell into 2 distinct groups with half responding distressed and half non-distressed during the immunization. Mothers of these children who rated their children as highly anxious prior to the procedure had children who were most likely to be observed to be distressed during the procedure.

Adolescent↗

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