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Biomedical subjects

R Ludwick

Publications and source records attributed to R Ludwick.

At least 19 recordsLinked to original sources
PubMed2006

Factors influencing nurses' judgements about self-neglect cases.

From the perspective of the practising nurse self-neglect may best be understood in terms of a set of complex and often poorly defined clinical problems in which two key clinical issues are "how do I judge whether this person has the capacity to make decisions about their lifestyle?" and "do we need to treat this person using mental health legislation?" These are taxing questions as judging if a patient has the capacity to make decisions about their lifestyle choices is difficult for even the most experienced clinicians. Such determinations require nurses to form a judgement as to mental capacity of the patient. We do not know what patient characteristics and in what combination nurses use these when making these judgements. This factorial survey aimed to identify which patient characteristics influenced Registered Nurses' judgements on decision-making capacity and decisions on the use of interventions which require statutory interventions in cases of self-neglect. Judgements on decision-making capacity were overwhelmingly predicted by information of the patients' mental health status. Nurses place patients in one of three broad categories of no mental illness, minor mental illness and severe mental illness. This categorization appears to operate as a fast and frugal heuristic indicating that nurses may use mental status as a cognitive screen to work from in judging self-neglect. Although there is a correlation between the severity of mental illness and the capacity for making decisions they are not the same. This study shows the continued work that needs done in educating nurses not only about self-neglect but also about the role a patient's mental status may have in assessment of problems.

Adult↗
PubMed2001

Breast self-exams by teenagers: outcome of a teaching program.

Teaching breast self-care as breast changes occur in the adolescent girl can influence positive behaviors such as performing breast self-examinations and seeking regular professional breast examinations. Health promotion behaviors often are taught in high school, but little research has been performed on teaching breast health in a high school setting. Therefore, this descriptive study aimed to identify the beliefs, knowledge, and practices of breast self-examination in adolescent girls. A pre- and posttest design was used to determine whether a teaching program would change beliefs, knowledge, and practices of breast self-examination. The results of this study demonstrate that a one-time intervention can be successful in increasing breast self-examination practice and the knowledge of breast self-examination and cancer in adolescents. Before the intervention, approximately 66% of students said they never examined their breasts, and only 3% performed breast self-examination monthly. In 1 month after teaching, these percentages changed appreciably, with 32% of students reporting that they never practiced breast self-examination and 23% reporting that they practiced breast self-examination monthly.

Adolescent↗
PubMed2001

The nursing shortage and ethics: up front and personal.

In times of crisis it is often that values and beliefs and, subsequently, our ethics are challenged. Authors in OJIN have addressed some of the ethical issues that nurses face in relation to crises in health care. For example, P. J. Maddox (1998) addressed ethical issues surrounding economic constraints and scarce resources. In this current issue of OJIN, Cheryl Peterson (2001) writes of the ethical dilemma nurses face in trying to comply with the Code for Nurses with Interpretive Statement, 1985 in light of the present nursing shortage. We invite you to read these and the other OJIN articles on the shortage and then submit to this column a story about how the nursing shortage has ethically affected you or your patients/clients.

Ethics, Clinical↗
PubMed2000

Electronic publishing: the movement from print to digital publication.

This article provides an overview of electronic publishing, describes how information increasingly is being exchanged within the scientific community, and discusses the scholarly qualifications of electronic venues. The following content is included: a.definition of electronic publishing; b.uses and types of electronic publishing; c.uses of electronic journals in nursing and health care; d.advantages and disadvantages of electronic journals; e.advantages and disadvantages of print journals; and f.the authors' projections for the future. Hotlinks to a variety of Internet resources on electronic resources are integrated throughout the article.

Delivery of Health Care↗
PubMed1998

Ethical issues and critical thinking: students' stories.

Through the stories told by these students it is evident that beginning students do think critically and act ethically during their first clinical nursing course. Ethical dilemmas involving students and staff, patients, faculty, and peers depict beginning students' development of values as they evolve into professionals. The conscientiousness and caring displayed by beginning students is apparent from students' shared perspectives. It is particularly encouraging that they seemed to focus more on values and cognitive aspects of patient care than on primarily technical psychomotor skills such as taking blood pressures and giving injections. Teaching beginning students is a challenge because the educator's role is twofold: Help students build a foundation for developing ongoing critical thinking abilities and help students develop an ethical view of patient care. Further exploration of critical thinking and ethical decision making should emphasize the mutual student-educator roles in facilitating self-awareness, through conscious awareness of their beliefs, values, feelings, and multiple perspectives. Because nursing emphasizes the human element and student nurses deal with human lives, educators play a vital role in facilitating the development of beginning students as critical thinkers and as ethical nurses. The most knowledgeable and most psychologically mature faculty are needed to teach beginning nursing students. Through ongoing reflection and critical thinking, nurse educators can help beginning students to identify and develop multiple perspectives on the ethics of nursing practice.

Clinical Competence↗
PubMed1996

The confused patient: nurses' knowledge and interventions.

The purpose of this study was to identify nurses' knowledge and experience about confusion and its treatment. A random sample of hospital-based, medical-surgical registered nurses (N = 100) was surveyed about their contact with confused patients and their knowledge about confusion. The findings suggest that nurses have regular and frequent contact with confused patients, caring for approximately three such patients in a week. They believe they are knowledgeable about confusion, rating their own knowledge on average as 2.96 on a scale ranging from 0 to 4. Restraint is the major treatment used for confusion, with 84% of the nurses reporting that the last confused patient they cared for was restrained. The high incidence data for use of restraints raise questions about what is a necessary restraint and whether restraints are overused in hospital settings. More attention needs to be directed toward finding alternatives to the use of restraints in the acute care hospital.

Adult↗
PubMed1993

Factors influencing success or failure in the AH-64 course.

A greater percentage of qualified student pilots fail the AH-64 (Apache) transition than any other advanced aircraft transition in the Army. We studied 140 consecutive students presenting for training in an effort to identify factors which might predict success or failure in the AH-64 course. Questionnaires were used to elicit demographic, anxiety level, and motion sickness history information prior to beginning Apache flight training. Motion sickness symptoms (MSS) during the enclosed cockpit, or "bag," phase of training were quantified using pre- and postbag flight symptom questionnaires. Performance measures included grades and flight hours required to pass the course. Only one piece of information obtained prior to flight training was related to performance in the AH-64 course; i.e., students who requested the transition performed measurably better than students who did not. While 7% of pilots described significant MSS on the first day of enclosed cockpit flight, this decreased to 2% by day 5. Severity of symptoms during bag phase was not related to any measure of subsequent performance.

Achievement↗
PubMed1992

Registered nurses' knowledge and practices of teaching and performing breast exams among elderly women.

This study was designed to identify registered nurses' knowledge and beliefs regarding breast cancer in elderly women, and to identify the practices of registered nurses in performing breast exams and teaching breast self-examination (BSE) to this client group. Correlational analysis using Pearson moment correlation showed a weak inverse relationship between nurses' attitudes toward the elderly and performing and teaching breast exams. As the nurse's negativism about aging increased, the incidence of teaching and performing exams decreased. A strong relationship was found between thorough and regular examination of the nurse's own breasts and performance of the exam on elderly women. As predicted, nurses were more likely to perform than teach exams. Using logistic regression, it was found that nurses who were employed full-time, married nurses, nurses who reported encouragement for themselves to do the exam, and nurses who were confident in examining themselves were more likely to examine the breasts of the elderly women. Nurses were more likely to teach BSE when they had a family history of breast cancer, spent greater than 50% of their time on direct care, reported belonging to a nursing association, were confident in detecting a lump in their own self-exams, and had a baccalaureate degree or higher.

Aged↗
PubMed1981

Alzheimer disease: lack of effect of lecithin treatment for 3 months.

Eleven outpatients with Alzheimer disease of moderate severity completed a double-blind placebo-controlled crossover trial of lecithin. Each patient received 10 gm three times daily of a placebo for 3 months. Plasma choline levels rose threefold and remained at that level throughout the lecithin administration period. A significant difference between mean baseline scores and treatment scores was found on tests of new learning ability, indicating a practice effect in these tests. However, there were no differences between mean placebo and lecithin scores on any of the psychological test measures.

Aged↗
PubMedDate not supplied

Breast cancer and the older woman: information and images.

Breast cancer is the most prevalent form of cancer in elderly women. Information on breast cancer explicitly relevant to elderly women was examined in 113 articles in the professional nursing literature and popular magazines. Content analysis on the nature or extent of information about breast cancer indicated that authors in the professional nursing literature and the popular media have inadequately addressed the degree of risk and the special needs of the elderly woman. Few authors in either the lay or professional literature have explicitly discussed the needs of elderly women, nursing research on breast cancer typically did not include elderly women, and popular articles and accompanying photographs tended to feature younger women.

Age Factors↗
PubMedDate not supplied

The factorial survey: an experimental method to replicate real world problems.

BACKGROUND: Vignettes are used by nurse researchers use to determine how clinical judgments about patient care situations are made. However, when vignettes are designed there is often a restriction on the number of characteristics studied, which oversimplifies the richness and complexity of real world healthcare situations. OBJECTIVES: The purpose of this article is to describe a factorial survey. Its multilevel design of independent variables allows for real world complexity in a way not tested by a sample set of four to six identical vignettes. Nurses' judgments about patients' confusion and the application of restraints are used to illustrate the method. METHOD: The factorial survey is an experimental design that can be developed in three steps: (a) identifying and using the variables, (b) writing a coherent vignette, and (c) randomly generating the vignettes. RESULTS: The unit of analysis is the vignette and Ordinary Least Squares (OLS) regression is used for analyses. In the example provided on confusion recognition and restraint use, patient characteristics accounted for the majority of explained variance in confusion recognition of (40%, R2 = 0.40) and restraint intervention for (43%, R2 = 0.43). The results for both models were strikingly similar as the same patient characteristics all were significant predictors for confusion recognition and restraint use. CONCLUSIONS: The versatility of the factorial survey lies in the researcher's ability to use it to test judgments in a variety of complex clinical simulations, to aid in concept development, and to identify consensus and disagreement among nurses. The multilevel design of the independent variables allows for real world complexity in a way not tested by a sample set of four to six identical vignettes.

Clinical Competence↗
PubMedDate not supplied

Dressing up nursing diagnoses: a critical-thinking strategy.

Teaching nursing diagnoses to beginning students who have no clinical experiences challenges educators to use their creative energies in developing strategies that facilitate students' critical-thinking skills. Dressing Up Nursing Diagnoses is a fun and creative classroom teaching strategy you can use during the Halloween season to help beginning students formulate nursing diagnoses. Two nurse educators describe their successful experiences with this unique teaching strategy.

Clinical Competence↗
PubMedDate not supplied

Documenting the scholarship of clinical teaching through peer review.

The essence of teaching is to make a positive difference in the lives of students. To this end, the nursing department at Kent State University developed and implemented a faculty-driven, voluntary program for peer review of clinical teaching. The authors describe the clinical peer review program and its positive outcomes.

Clinical Competence↗