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Biomedical subjects

P R Mobily

Publications and source records attributed to P R Mobily.

13 recordsLinked to original sources
PubMed1994

Validation of cutaneous stimulation interventions for pain management.

The purpose of this study was to identify and validate specific activities considered important in the implementation of selected cutaneous stimulation pain management interventions including heat and cold application, massage and Transcutaneous Electrical Nerve Stimulation (TENS). A two-round Delphi survey was completed by nurses selected for their expertise in pain management. Data were analyzed using a modification of Fehring's diagnostic content validity method. Consistently high scores were obtained by the raters for each intervention and activity, with most activities perceived as critical to the intervention. From this process, a list of activities for each cutaneous stimulation intervention evolved that are applicable to education, clinical practice and clinical nursing research.

Cryotherapy↗
PubMed1993

Cognitive-behavioral techniques to reduce pain: a validation study.

The purpose of this study was to identify and validate specific activities considered important in the implementation of three non-pharmacologic pain management interventions--relaxation, distraction and guided imagery. Using a two-round Delphi survey, nurses selected for their expertise in pain management were asked to validate definitions and activities considered important in the implementation of each of these strategies. Data were analyzed using a modification of Fehring's diagnostic content validity method. From this process, a list of activities for each intervention evolved that has implications for nursing research, practice and education.

Analgesia↗
PubMed1993

Depression and the experience of chronic back pain: a study of related variables and age differences.

OBJECTIVE: To document the prevalence of depression and examine the relationship between depression and selected pain-related variables associated with chronic back pain among elderly and nonelderly samples. DESIGN: Survey with mailed questionnaire. SETTING: Patients seeking treatment at a spine diagnostic and treatment center. PATIENTS: Consecutive sample of elderly subjects (n = 69). Nonelderly subjects (n = 59) were randomly selected to achieve a sample size comparable to the elderly. Evaluation of depressed mood was determined by Beck Depression Inventory. MAIN OUTCOME MEASURES: Multidimensional Pain Inventory, Pain Disability Index, Pain Duration, Work-Related Disability, Medication Use, and Pain Severity. RESULTS: A high prevalence of dysphoria was found in both age groups. No significant differences were found between age and depressed mood. The only significant association between depressed mood and age occurred with pain duration, with the elderly experiencing fewer total hours per day in pain. Combining age groups, multivariate analysis of variance revealed that dysphoric chronic pain patients reported more antidepressant use, greater pain intensity, greater interference due to pain, and less life control than the nondepressed patients. Interference in activities demonstrated the strongest relationship with depressed mood in both age groups. CONCLUSIONS: There is a high prevalence of dysphoria in both the elderly and nonelderly with chronic back pain. The relationships between pain-related constructs and depressed mood in chronic back pain patients are similar in the elderly and nonelderly. The impact of the pain experience on the individual's activities, functioning, and feelings of life control should be considered in theoretical and clinical explanations of the association between pain and depression.

Adult↗
PubMed1992

Chronic pain and depression.

Because of the increased incidence of chronic disease and other health problems associated with aging, chronic pain is a common companion for the elderly. Pain is of great clinical importance, often associated with disability, loss of independence, and reduced quality of life. A fact that is of interest to psychiatric nurses is that many elderly with complaints of chronic pain also exhibit signs and symptoms of depressive disorders. Treating chronic pain conditions is complex and difficult, and health-care professionals are increasingly recognizing that psychological factors are often involved in the development and continuation of chronic pain problems. Depression is one of these influential variables. Increased understanding of the role of depression in the etiology and maintenance of chronic pain can improve assessment and intervention for the elderly with chronic pain complaints.

Aged↗
PubMed1992

Staff stress on an Alzheimer's unit.

Nurses working with the elderly encounter many complex and potentially stressful care situations. Nowhere is this more true than for nursing home staff who work in highly demanding, labor- and client-intensive jobs. A number of factors contribute to the high levels of stress found among nurses who work with the elderly, including continual exposure to physical and emotional pathology and death, and conflict with families, co-workers, supervisors, and representatives from other departments or professions (Goldin, 1985; Klus, 1980). When the stress level in a long-term care facility becomes overwhelming, role conflict, ambiguity, poor self-esteem, and burnout may ensue (Goldin, 1985; Heine, 1986; Klus, 1980; Morrow-Winn, 1985). The process of burnout is characterized by a progressive loss of idealism, energy, and purpose that eventually leads to emotional overextension and exhaustion (Price, 1984).

Adult↗
PubMed1992

Interventions related to pain.

A two-round Delphi survey was completed by pain experts to achieve consensus on 10 selected pain interventions and associated activities characteristic of each intervention. Consistently high scores were obtained by the raters for each intervention and activity, with most activities perceived as critical to the intervention. Interventions with more specific activities were rated highest by the expert judges. Expert feedback indicates the complexity of establishing a list of activities for selected interventions when dealing with pain of various types, with different causes and for different patient populations. The expert raters clearly see assessment and evaluation activities as part of the intervention strategies for each intervention. Further research is needed to validate the interventions and activities with nurse experts from varying clinical specialty areas in the practice setting.

Delphi Technique↗
PubMed1991

Leg pain in the rural Iowa 65+ population. Prevalence, related factors, and association with functional status.

Research tabulating the existence and effects of pain and related factors in the elderly is lacking, in spite of the continued growth of the aged population. Leg pain, in particular, may interfere with activities and interpersonal interactions. This study of 3,097 rural elderly examines the prevalence of complaints of leg pain and related factors in a geographically-defined population. Findings indicate that leg pain is clearly a common experience which impacts daily activities of the elderly.

Age Factors↗
PubMed1991

Complexities of pain assessment in the elderly. Clinical considerations.

Establishing a trusting, caring relationship that acknowledges suffering and demonstrates caring is an important first step toward pain management in the elderly. The content of assessing pain in the elderly is similar to that for younger individuals. However, the source of information, manner and timing of assessment, method, and amount of data collected must be adapted to meet the special needs of the elderly individual. Strategies for assessing pain in the elderly must be adapted for those with sensory, cognitive, or psychomotor deficits. Many tools currently available for assessing pain may be effective when adapted to accommodate these changes. Interpreting reports of pain and pain-related behaviors in the elderly is complicated by myths and misunderstandings commonly held by the elderly and many health professionals. Careful consideration must be given to the meaning of pain or lack of pain report, as well as personal biases, which may influence the interpretation of pain behaviors.

Aged↗
PubMed1991

Iatrogenesis in the elderly. Factors of immobility.

Mobility of elderly patients is a consequence of the interaction between factors including biological health, sensory-perceptual capacity, motor skills, cognitive capacity, and ego-strength; and environmental resources including physical and architectural features, medical regimens, institutional policies, resident and staff characteristics, and social support availability. Impaired mobility, whether self- or other-imposed, places the elderly at risk for a multitude of negative physiological and psychological consequences that can affect health, well-being, and quality of life. Understanding the basic mechanisms underlying the physiological and psychological consequences of immobility, the relative time-frame in which they can develop, and the concomitant changes associated with aging provides the basis for interventions aimed at preventing or minimizing them. A multitude of factors that influence the elderly's state of mobility are within nursing's realm of practice. Although elderly patients may present a special challenge, the negative consequences of immobility can be avoided, to a significant extent, with astute and vigilant nursing management.

Aged↗
PubMed1991

Iatrogenesis in the elderly. Impaired skin integrity.

Risk factors that contribute to pressure ulcer formation include immobility and inactivity, age, malnutrition, fecal and urinary incontinence, and a decreased level of consciousness. Gerontological nurses should collaborate with other health disciplines (eg, the physician, physical therapist, and dietitian) to plan and provide preventive treatment measures for the elderly person with potential for impaired skin integrity: pressure ulcers. Gerontological nurses must continue the development and refinement of tools with which to predict the degree of risk for impaired skin integrity, as well as use a consistent method of grading pressure ulcers.

Aged↗
PubMed1991

An examination of role strain for university nurse faculty and its relation to socialization experiences and personal characteristics.

The purpose of this study is to describe the degree of perceived role strain and the major sources of role strain in nurse faculty employed in major universities; and to explore the relationship between selected socialization experiences and personal characteristics and the degree of role strain experienced. The sample (N = 102) was comprised of full-time tenure track nurse faculty employed in major universities that offered National League for Nursing-accredited undergraduate and graduate programs in nursing, and were located in institutions classified as Research Universities I by the Carnegie Council on Policy Studies in Higher Education (1987). The majority of faculty were experiencing some degree of role strain, with a substantial number experiencing moderate to high degrees of role strain. The major sources of role strain were role overload and both intrasender and interrole conflict. Analysis of the relationship between socialization experiences and personal characteristics and the degree of role strain experienced revealed nine statistically significant relationships. Implications for administrators and faculty are discussed.

Burnout, Professional↗