Biomedical subjects

N Thom

Publications and source records attributed to N Thom.

3 recordsLinked to original sources

PubMed2001

Clinical supervision and support for nurses: an evaluation study.

AIM: To assess the effects of clinical supervision and informal support on qualified nurses. RATIONALE: Earlier small-scale research studies have provided conflicting evidence about the impact of clinical supervision, hence the need for this larger-scale study. DESIGN: Survey design drawing on an opportunity sample of 211 qualified nurses from 11 randomly selected hospital and community NHS Trusts in one region in England. Quantitative data collection used the Maslach Burnout Inventory (MBI) and the Nursing in Context Questionnaire (NICQ), while qualitative data were based on written critical incidents. The analysis compared supervized with unsupervized nurses. FINDINGS: The critical incident analysis revealed that supervized nurses continued to use informal support networks as well as their supervision sessions to discuss clinical issues. The MBI found no significant differences in levels of burnout between supervized and unsupervized nurses. However, the NCIQ detected some statistically significant differences, with supervized nurses reporting a more listening and supportive management, coping better at work and feeling that they had better access to support than unsupervized nurses. Closer analysis found that this positive finding was particularly strong among the more junior supervized nurses. CONCLUSION: Where resources are limited, it is better to concentrate on providing clinical supervision to more junior grades of nurses as a valued form of support during their early years as qualified practitioners.

Adaptation, Psychological↗

PubMed1992

[Abdominal multivisceral resection of colonic cancer].

Multivisceral resection in combination with extended lymph node dissection is used in the surgical treatment of locally advanced colon carcinoma without distant metastases. This also applies to tumours with marked peritumorous inflammation in contact with neighbouring organs where an intraoperative diagnostic attempt could result in tumour seeding. The low mortality and complication rate following multivisceral resection justifies this concept. The 5-year survival rate following multivisceral resection in advanced colon carcinoma is over 80%.

Abdominal Neoplasms↗

PubMed1992

[Pelvic multivisceral resection from the viewpoint of surgery].

Even rectal carcinomas, carcinomas of the female genital tract, and retroperitoneal sarcomas of the pelvis with invasion of adjacent organs are potentially curable by extending the operation to the relevant structures. In the Surgical Department of the University of Erlangen, 1535 patients with a first diagnosis of rectal carcinoma were treated from 1978 to 1988. Among these patients, 97 multivisceral pelvic resections (patients with distant metastases excluded) were performed. True tumor invasion had occurred in 48%, the others were operated on for inflammatory adhesion. In 54 patients, the anal sphincter was preserved. Postoperative mortality was 7%. The 5-year survival of those patients with tumor invasion of adjacent organs and R0-resection (n = 26) was 32%. Excluding the five patients with a tear or incision of the tumor (n = 5), the 5-year survival of the remaining patients was 44%. One patient who was operated on for a leiomyosarcoma of the rectum with a multivisceral resection of the rectum, prostate, and urine bladder is still alive 9 years after the operation without recurrence. The history of this patient argues for pelvic exenteration also in males, if a R0 resection can be performed.

Female↗