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Biomedical subjects

P K Nicholas

Publications and source records attributed to P K Nicholas.

At least 19 recordsLinked to original sources
PubMed2006

Strategies for self-management of HIV-related anxiety.

This study examines the frequency and effectiveness of commonly used strategies for self management of anxiety in an international sample of 502 participants from Norway (n=42, 8%), Taiwan (n=35, 7%), and the US (n=426, 85%). An activities checklist summarized into five categories of self-care behaviours including activities/thoughts, exercise, medications, complementary therapies, and substance use determined self-care behaviours. Ratings of frequency and effectiveness for each self-care activity were also included. Praying received the highest overall rating of effectiveness of any self-management strategies included in this study at 8.10 (scale 1 to 10), followed by meditation (7.37), exercising (7.32), using relaxation techniques (7.22), cooking (6.98), and walking (6.90). An analysis of effectiveness scores for each self-care strategy by country reflected a wide variation. The three most effective anxiety self-care strategies reported by participants from Norway included exercise (7.31), walking (6.96), and reading (6.44). Highest ratings of effectiveness by participants from Taiwan included talking with others with HIV (6.0), attending support groups (6.0), and exercising (6.0). US participants allocated highest ratings of effectiveness to complementary/alternative therapies, including praying (8.10), meditating (7.43), and using relaxation techniques (7.35). Regardless of the country, watching television and talking with family and friends were the two most frequently reported strategies. These strategies for self-management of HIV-related anxiety are important for clinicians to be aware of in the care of persons with HIV/AIDS.

Adult↗
PubMed2006

The impact of meaning in life and life goals on adherence to a tuberculosis medication regimen in South Africa.

SETTING: Out-patient tuberculosis (TB) clinics in Durban, South Africa. OBJECTIVE: Health care provider concerns about persons with active TB defaulting on medications led to a study of adherence among persons receiving anti-tuberculosis therapy and, specifically, the relationships between meaning in life, life goals, sense of coherence, social support, symptom presence and intensity, and adherence in individuals diagnosed with TB. DESIGN: A cross-sectional, descriptive design was used to gather self-reported data from TB-infected individuals who were enrolled in out-patient clinics. Data were collected from 159 Zulu and/or English-speaking persons who agreed to participate in the study. RESULTS: A significant relationship was found between higher life goals and adherence to TB treatment (P = 0.027). Analysis of variance revealed that higher meaning in life ratings were significantly associated with older age (P = 0.007). Having children and children living in the same household were significantly associated with low meaning in life ratings (P = 0.006 and P < or = 0.001, respectively), indicating that these individuals were more concerned about basic matters of home and sustenance. CONCLUSIONS: The results of this study indicate that meaning in life and life goals may be useful for identifying individuals who will require additional support in adhering to anti-tuberculosis treatment.

Adolescent↗
PubMed2002

Self-care management for neuropathy in HIV disease.

Peripheral neuropathy is the most common neurological complication in HIV and is often associated with antiretroviral therapy. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of peripheral neuropathy in HIV disease, the self-care strategies, and sources of information for self-care utilized by the sample. A convenience sample of 422 respondents was recruited from an Internet web-based site developed by the University of California, San Francisco International HIV/AIDS Research Network and from five geographic data collection sites (Boston, New York City, San Francisco and Paterson in the USA, and Oslo, Norway). Results of the study indicated that respondents with peripheral neuropathy identified 77 self-care behaviours including complementary therapies, use of medications, exercise and rest and/or elevation of extremities. Sources of information included health care providers, informal networks and media sources.

Adult↗
PubMed2001

Issues in cross-cultural quality-of-life research.

PURPOSE: To examine cross-cultural measurement of quality of life (QOL) and issues to consider in adapting quality-of-life instruments. ORGANIZING CONSTRUCT: Health-related quality of life. METHODS: Review of the literature on cross-cultural QOL using the Cumulative Index to Nursing & Allied Health Literature (CINAHL), 1982 to February 2000, and Medline, 1966 to May 2000, databases. FINDINGS: Use of research instruments beyond the samples with which they were initially tested, particularly if the new samples are cross-cultural, presents considerable challenges. The findings indicate consideration of these problems: phenomenon of interest, cross-cultural versus cross-national, salience, conceptual equivalence, cultural hegemony versus cultural validity, cultural equivalence versus verbal equivalence, fidelity versus appropriateness, privacy versus disclosure, appropriateness of format, and resource utilization for translation. Although the literature indicates increased discussion of theoretical, conceptual, and operational approaches to measuring cross-cultural QOL, problems continue in adapting instruments from one culture to another. CONCLUSIONS: Many issues about cross-cultural QOL were identified. By addressing these issues, researchers can develop appropriately translated and validated quality-of-life instruments to advance knowledge about cross-cultural QOL.

Cross-Cultural Comparison↗
PubMed2001

Adolescent violence. Assessment of nurses' attitudes and educational needs.

Adolescent violence is a major public health problem. Because of their roles in community and hospital settings, nurses have an opportunity to limit the epidemic of violence. The purpose of this study was to examine the perceived levels of knowledge, the value of further education, resource utilization, and attitudes of nurses caring for adolescent victims of violence. Data were collected from 60 nurses employed at an urban public hospital. Results of the study indicate that 50% of the respondents had high scores on the perceived knowledge section of the survey. However, the majority of nurses (82.5%) felt inadequately educated about violence. The attitudes reported with the most frequency were frustration (78%), anger (59%), and powerlessness (58%). The results of this study indicate a need for additional violence education for nurses, particularly in the areas of available resources and intervention for adolescent victims of violence.

Adolescent↗
PubMed2000

Long-term continuum of care for people living with HIV/AIDS.

The introduction of highly active antiretroviral therapy (HAART), has created new options for those infected and affected by human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS). Most HIV-infected persons no longer die within months of diagnosis. There is now a long-term continuum of care that can end in misery or relative comfort. The introduction of palliative care in concert with curative therapies throughout the disease trajectory should be the standard of care for all persons. At the very least, the introduction of palliative care and hospice at the end of life is important to the holistic care of persons living with HIV/AIDS.

Anti-HIV Agents↗
PubMed2000

The use of complementary and alternative therapies.

The National Center for Complementary and Alternative Medicine (NCCAM) was created by Congress in 1998 as part of the National Institutes of Health. As interest in alternative and complementary therapies among healthcare providers and consumers has increased in recent years, the NCCAM has provided research funding to determine the efficacy of various types of unconventional treatments. The Center also provides research training and acts as a clearing-house for information dissemination to practitioners and the general public. Inclusion and exclusion criteria for alternative and complementary medicine as defined by the NCCAM are provided. Interest in these non-traditional treatments will likely continue to increase over the next few years. The NCCAM is playing a vital role as it provides avenues to determine how these therapies can lead to enhanced quality of life for individuals as we enter the new millennium.

Complementary Therapies↗
PubMed1999

Predictors of self-reported adherence in persons living with HIV disease.

This study examined the relationships between the five dimensions of the Wilson and Cleary model of health-related quality of life and three self-reported adherence measures in persons living with HIV using a descriptive survey design. Data collection occurred in seven cities across the United States, including university-based AIDS clinics, private practices, public and for-profit hospitals, residential and day-care facilities, community-based organizations, and home care. The three dependent adherence measures studied were "medication nonadherence," "follows provider advice," and "missed appointments." The sample included 420 persons living with HIV disease with a mean age of 39 years of which 20% were women and 51% were white; subjects had a mean CD4 count of 321 mm3. HIV-positive clients with higher symptom scores, particularly depression, were more likely to be nonadherent to medication, not to follow provider advice, and to miss appointments. Participants who reported having a meaningful life, feeling comfortable and well cared for, using their time wisely, and taking time for important things were both more adherent to their medications and more likely to follow provider's advice. No evidence was found demonstrating any relationship between adherence and age, gender, ethnicity, or history of injection drug use. These findings support the need to treat symptoms, particularly depression, and to understand clients' perceptions of their environment as strategies to enhance adherence. A limitation of this study was that adherence was measured only by self-report; however, the study did expand the concept of adherence in HIV care beyond medication adherence to include following instructions and keeping appointments.

Adult↗
PubMed1999

Hardiness, social support, and health status: are there differences in older African-American and Anglo-American adults?

The article reports a study examining the relationships among hardiness, social support, and health status in older African-American and Anglo-American adults (n = 110). The theoretical framework of the study was based on the interrelationships of the personal resources of hardiness, social support, health status, and sociodemographic factors, including race. Pearson's correlation coefficients and t tests were performed to examine the relationships among the variables. Hardiness correlated significantly with greater social support, better perceived health status, increasing age, and lower income. Social support correlated significantly with better perceived health status, increasing age, and higher income. Perceived health status correlated significantly with lower age. Older Anglo-American adults had significantly higher scores on hardiness, whereas older African-American adults had significantly higher scores on social support. Implications for holistic nursing practice are discussed.

Adaptation, Psychological↗
PubMed1997

Prostatitis: diagnosis and treatment in primary care.

Prostatitis refers to the inflammation and/or infection of the prostate gland, which occurs in several forms or syndromes and presents with varied etiologies, clinical features, and sequelae. The four common forms of prostatitis are acute bacterial prostatitis, chronic bacterial prostatitis, nonbacterial prostatitis, and prostatodynia. Differential diagnosis of prostatitis is based on history, physical exam findings, and, frequently, analysis of expressed prostatic secretions. Complaints may vary, but pain or discomfort in the rectal or perineal area is usually present. Clinicians in primary care settings should be knowledgeable about the types of prostatitis, etiology, and pathogenesis; the methods of diagnosis; and treatment/education issues.

Decision Trees↗
PubMed1996

Health care and nursing in Romania.

Health care and the nursing profession have been affected dramatically by political and socio-economic conditions in Romania. The Romanian Ministry of Health has recognized the health problems and barriers to care delivery which exist in the country, with several goals identified to improve the status of Romanian health care. This paper explores the critical issues which have impacted on health care and nursing in Romania.

Delivery of Health Care↗
PubMed1996

A behavioral medicine intervention in persons with HIV.

This study used a pretest-posttest preexperimental design to examine the effect of a 10-week behavioral medicine support group intervention in a sample of persons with HIV. Using Solomon's psychoneuroimmunologic framework, the 10-week behavioral medicine program focused on the mind/body interaction, the relaxation response, coping with illness, hardiness, and nutrition. Pearson correlation coefficients and t tests were performed on the pre- and postintervention measures of hardiness, social support, immune function, and perceived health status. Results of the study indicated that hardiness (preintervention) and CD4 counts (pre- and postintervention) were significantly correlated with health status; however, CD4 counts decreased over the course of the behavioral medicine program. Implications for nursing and recommendations for further research are discussed.

Adult↗
PubMed1995

Social support, quality of life, immune function, and health in persons living with HIV.

The purpose of this study was to examine the relationship between social support and quality of life in individuals with HIV. Using a descriptive, correlational design, data were collected from 50 HIV-positive individuals who were: (a) participants in support groups at a behavioral medicine unit, (b) inpatient or respite care patients with HIV, or (c) respondents to advertisements at AIDS service organizations. Instruments used for data collection were the Personal Resource Questionnaire 85-Part 2 (Weinert, 1987), measuring perceived social support, and the Quality of Life Index (QLI) (Ferrans & Powers, 1985), measuring the sense of well-being in life including the satisfaction with and importance of life domains with four subscales: health and functioning, socioeconomic, psychological/spiritual, and family. The results of the study indicated that social support was significantly correlated with quality of life (r = 0.81, p < 0.0001). Further, HIV status (asymptomatic HIV, symptomatic HIV, AIDS) was significantly related to quality of life (p < 0.01). However, HIV status was not significantly related to social support. No significant relationship was found between CD4 counts and HIV status, CD4 counts and social support, or CD4 counts and perceived health status. However, CD4 counts were significantly correlated with scores on the QLI. The findings of the study indicate that social support and quality of life are significantly intercorrelated and that higher CD4 counts are related to quality of life in this sample of persons living with HIV. Further areas for research include evaluation of quality of life over the span of HIV disease and interventions aimed at enhancing or maintaining quality of life in persons across the spectrum of HIV disease.

Adult↗
PubMed1995

Evaluation of a problem-based access knowledge system using triangulation methods.

A microcomputer-based system designed to provide nurses and physicians access to expert synthesized knowledge in the area of pulmonary arterial waveform troubleshooting has been developed and implemented. Evaluation using triangulation methods show that there was a substantive increase in knowledge in both nurses and physicians.¿.

Attitude of Health Personnel↗
PubMed1994

Prevalence and characteristics of pain in persons with terminal-stage AIDS.

A retrospective chart review was undertaken to collect and report data on the prevalence and characteristics of pain in persons with terminal-stage AIDS. A convenience sample consisting of 50 patient charts at a residential AIDS hospice was utilized. Data were collected from the McCaffery Initial Pain Assessment Tool (IPAT) (1983) which was completed at the time of each hospice admission. The IPAT is composed of 10 sections that collectively describe the patient's pain experience. Demographic and AIDS-related pathology data were also collected. Data were analysed using descriptive statistics to examine the incidence and characteristics of pain. Pain was experienced by a majority of the subjects in the sample. Pain levels for 'present pain', 'worst pain gets', 'best pain gets' and 'acceptable level of pain' are reported. Characteristics of pain including location, causal factors and verbal descriptors are reported. Implications for nursing practice and suggestions for further research are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Hardiness, self-care practices and perceived health status in older adults.

The purpose of this study was to examine the relationship among hardiness, self-care practices and perceived health status in older adults. A random sample of older adults (n = 72) was selected from the population of a small north-eastern town in the United States. Self-report data were obtained on the Health-Related Hardiness Scale as a measure of hardiness, the Personal Lifestyle Questionnaire as a measure of self-care practices and the Visual Analogue Scale as a measure of perceived health status. It was hypothesized that older adults who had higher levels of hardiness and self-care practices would have a higher perceived health status and that hardiness and self-care practices combined would explain more of the variance in perceived health status than either variable taken individually. Statistical analyses supported the three hypotheses. The obtained significant correlation between hardiness and perceived health status was -0.68 (P < 0.001) (hardiness negatively scored). For self-care practices and perceived health status, the correlation was 0.46 (P < 0.001). The illness index, income and living circumstance accounted for 46% of the variance in perceived health status scores. Hardiness and self-care practices accounted for an additional 10% of the variance in perceived health status once these demographic and illness variables were controlled. Implications for nursing practice, education and research are discussed. Recommendations included replication of the study with a larger, more heterogeneous population. Suggestions for further investigation of the relationship between resistance resources such as hardiness and self-care practices and health status are presented.

Adaptation, Psychological↗