Biomedical subjects
Publications and source records attributed to R M Gerber.
Elderly patients with coronary artery disease (CAD) present special opportunities and challenges for nurses. The astute nurse is aware of changes in the aging cardiovascular system and possible alterations in the presenting signs and symptoms of CAD. Risk factor reduction may need to be approached more selectively in the elderly. Older patients who are treated surgically may experience more complications. Implications for nursing care are reviewed.
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To test the hypothesis that there will be a significantly greater increase in the rate of healing of decubitus ulcers in subjects who receive topical insulin therapy than in subjects who receive other forms of therapy, a pilot study was conducted, utilizing a two-group before and after design. Decubitus ulcers of six experimental group subjects were treated with a topical application of ten units of regular insulin twice a day for five days; eight control group subjects received one of a variety of topical therapies other than insulin. Data were collected on all subjects for a 15-day period. Although generalizations cannot be based on the results of 14 subjects, data analysis showed that insulin was a safe and effective agent in the healing of small, uncomplicated decubitus ulcers. The results appear to warrant a more extensive study of the subject.
When a pilot study provided evidence that insulin may increase the rate of healing of decubitus ulcers, this study attempted to answer the question: Is topical insulin therapy an effective treatment regimen for decubitus ulcers? The experimental study utilized a two-group, before-after design. Twenty-nine geriatric subjects were randomly assigned to either the experimental or the control group. The single independent variable was the topical application of ten units of regular insulin (U.S.P.) twice daily. The dependent variable was the surface area of the decubitus ulcer measured in square millimeters. Rate of healing was defined as decrease in surface area over time. Data were also gathered on extraneous variables believed to influence the healing process. The F test was used to test the research hypothesis that experimental subjects would have an increased rate of healing. When comparison of group means on day seven and day 15 revealed no significant differences, the research hypothesis was rejected. Pearson product moment correlation procedures were utilized to determine if there were differences between extraneous variables and the rate of healing. Females healed significantly (p less than .05) more slowly than males. Also, there was a direct correlation between the number of days of treatment and the rate of healing.
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A middle range, multivariate practice model was constructed to test the impact of a perioperative teaching program on multiple patient outcomes: coping, anxiety, recovery pattern, pain, and patient satisfaction. In addition, the influence of such a program on nursing staff was examined. A quasi-experimental, causal modeling approach was used. The operative trajectory of 88 patients and their operating room nursing staff was traced from two pre-operative points through the intra-operative stage to two points post-operatively. The experimental patients (n = 54) evidenced higher satisfaction with their care, a tendency to experience less post-operative vomiting, but also tended to recover more slowly and cope less well than the control patients (n = 34). Multiple regression analysis of the practice model suggested the perioperative teaching program affected patient outcomes, indirectly, through the functioning of the staff nurses intra-operatively.
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