Biomedical subjects
Publications and source records attributed to P LeMone.
Altered glycemic responses occur in patients with diabetes mellitus in hospital, home, and community settings. Adult health nurses play a key role in identifying risk factors, intervening, and teaching self-management.
The increasing number of adults with diabetes has implications for medical-surgical nurses. This article provides a knowledge base for individualized nursing assessments and interventions in caring for the older adult with diabetes.
This qualitative study was conducted to explore human sexuality in adults with insulin-dependent diabetes mellitus. Data from interviews of 11 men and women were used to formulate a substantive theory describing the process of changes in sexuality that occur in adults with this chronic illness. The core category of the theory is transforming, which is supported by the subcategories of valuing self and meeting intimacy needs. Information from the study can be used in nursing to provide client care, teaching and counseling for adults with insulin-dependent diabetes mellitus.
Moderate to severe trauma is followed by a local response, which involves changes in cell function and an inflammatory reaction, and a systemic response coordinated by the nervous and endocrine systems. Early post-trauma alterations in cells are due primarily to decreased oxygen supply and include 1) the shifting of electrolytes and water, either into or out of cells, and 2) the production or release of various local tissue factors. These tissue factors produce changes in blood flow, increased vascular permeability, and other local manifestations of inflammation. Trauma activates nervous and hormonal pathways which help to restore blood volume and maintain the function of essential organs. The effects of these responses on cellular oxygen consumption and body temperature are described. Examples of respiratory system involvement in response to trauma in the lungs or elsewhere are given. These include increased capillary permeability in the lungs, pulmonary emboli, and damage from smoke and heat inhalation.
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Increasing attention has been given in recent years to the importance of diet in promoting health and preventing illness. The benefits of specific food components that expand the role of diet in health promotion have been identified. With a variety of compounds readily available to consumers, more people are taking self-prescribed supplemental nutrients to maintain or improve health. Vitamins and minerals are essential to the health of women across the lifespan, but deficiencies may occur because of inadequate diet; life-style choices and habits; increased requirements during growth, menstruation, pregnancy, and lactation; menopause; and illness. Critical knowledge for women's health care practitioners includes the recommended daily allowances of vitamins and minerals, sources, factors affecting dietary intake and use, and considerations for nutritional assessment and intervention.
This analysis of self-concept includes an examination of definitions, historical perspectives, theoretical basis, and closely related terms. Antecedents, consequences, defining attributes, and a definition were formulated based on the analysis. The purpose of the analysis was to provide support for the use of the label "self-concept" as a broad category that encompasses the self-esteem, identity, and body-image nursing diagnoses within Taxonomy I. This classification could allow the use of a broad diagnostic label to better describe conditions that necessitate nursing care. It may also further explain the relationships between and among those diagnoses that describe human responses to disturbance of any component of the self-concept.
Human sexuality is a complex and multifaceted phenomenon that encompasses physical, psychological, and social components. The nursing diagnosis altered sexuality patterns labels the human response to alterations in sexuality that occur as the result of various health problems. This validation of the defining characteristics of the diagnosis was based on a substantive theory derived from a qualitative grounded theory study. In the original study, data from 11 adult insulin-dependent diabetics living in a rural area of the Midwest were analyzed and relevant experiences conceptualized through the core concept of transforming and the supporting concept of valuing self and meeting intimacy needs. The theory was then used as a framework to formulate specific defining characteristics for the nursing diagnosis. A single diagnosis of altered sexuality has emerged that encompasses the perception of change in sexuality as well as the change itself.
The authors conducted a retrospective study to validate gender-specific defining characteristics for the proposed nursing diagnosis altered sexuality. An investigator-designed tool was used to collect data from 100 randomly selected members of NANDA. The Fehring method of diagnostic content validity was used to identify major and minor defining characteristics for men and women. The defining characteristics identified and validated encompass all dimensions of human sexuality, and are more concise and descriptive of this human response than those currently in use. Findings of this study will be used to develop a tool for assessment of altered sexuality in a variety of populations and settings.
TOPIC: Nursing assessment of altered sexuality. PURPOSE: To review salient factors affecting assessment and objective measures available for use in assessment. SOURCE: Literature specific to nursing assessment of sexuality and to instruments measuring altered sexuality. CONCLUSIONS: Many standards of care include the assessment of sexuality, and nurses believe it to be an important aspect of care. However, the assessment of altered sexuality does not often occur in actual practice. The use of an objective measure of sexuality is recommended for both initial and on-going assessments in acute-care and community-based settings.
Diabetes is a chronic illness that affects all aspects of human sexuality. As an integral part of a woman's day-to-day life, sexuality may be adversely affected by diabetes in ways that are detrimental to her total health, her relationships, and her self-esteem. This descriptive study was conducted to describe the physical effects of diabetes on sexuality in women with insulin-dependent diabetes or non-insulin-dependent diabetes. A sample of 20 women were interviewed and data were analyzed to identify themes. Problems reported by subjects affecting sexuality were fatigue, changes in perimenstrual blood glucose control, vaginitis, decreased sexual desire, decreased vaginal lubrication, and an increased time to reach orgasm. Continued research is recommended to further explore these findings.
This pilot project was conducted to evaluate the effectiveness of the modes of adaptation described by Roy as a framework for assessing psychosexual concerns of adults with diabetes mellitus. A structured interview guide with questions that elicited information in physiologic, self-concept, role function, and interdependence modes was used to interview 10 hospitalized men and women with diabetes. Findings from the study are presented. Limitations in the interview guide are identified and recommendations for refinement and further development of the guide to elicit more specific information and to more clearly separate responses into discrete modes are discussed.
Academic nursing centers, owned and administered by schools of nursing, provide ambulatory care in settings in which nurses are both health care providers and clinic managers. Such centers are growing in number within the United States (1,2). In contrast to academic health centers that are based on a medical model, they "give the client direct access to professional nursing services ... using nursing models of health" (3). Academic nursing centers provide accessible and affordable health care services to a variety of clients, including women and children, the elderly, the homeless, minorities, and low-income and underserved persons. They are based in diverse settings--schools of nursing, senior or neighborhood centers, public housing projects, storefronts, churches, schools, and mobile vans--and in some instances, they serve as home care providers (4). They have in common their ownership by schools of nursing.