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Biomedical subjects

S Janson-Bjerklie

Publications and source records attributed to S Janson-Bjerklie.

At least 19 recordsLinked to original sources
PubMed1993

Predicting the outcomes of living with asthma.

The purpose of this study was to explore the impact of person and disease predictors on psychosocial and morbidity outcomes in adults with chronic asthma. Ninety-five asthmatic adults were followed for 60 days with standardized questionnaires and three interviews. Amount of distress during an asthma episode, perceived danger from asthma, and appraisal of social support were predictors of emergency room visits. Self-care, perceived life stress, nocturnal symptoms, and amount of distress during an asthma episode were predictors of depression. Financial status and the absence of nocturnal symptoms of asthma predicted life satisfaction.

Adaptation, Psychological↗
PubMed1993

The HIV quality audit marker (HIV-QAM): an outcome measure for hospitalized AIDS patients.

The development and validation of the HIV-Quality Audit Marker (HIV-QAM), an instrument designed to measure changes in the status of hospitalized AIDS patients due to nursing care, is reported. The HIV-QAM is designed to capture the nurse data-collector's judgment of the status of the patient based upon observations, interviews, record reviews, and listening to inter-shift report. The final version of the 10 item HIV-QAM includes three scales, Self-care (six items; Cronbach's alpha = 0.89), Ambulation (two items, alpha = 0.88), and Psychological Distress (two items, alpha = 0.84). Content validity was supported by selection of items from pre-existing scales, generation of items based on care plans for HIV/AIDS patients, and review and critique of items by a panel of nurse experts. Construct validity was supported by principal components factor analysis and multi-trait scaling analysis. Convergent and divergent concurrent validity with patient symptoms and intensity of nursing care required was demonstrated. The predictive validity of the HIV-QAM for mortality at 3 and 6 months after hospital treatment for Pneumocystis carinii pneumonia was also shown.

Activities of Daily Living↗
PubMed1993

The dilemma of seeking urgent care: asthma episodes and emergency service use.

Asthma is an invisible and unpredictable chronic illness characterized by recurrent episodes of airflow obstruction and airway inflammation. Until recently, psychological factors were thought to play a major role in this condition. The notion of an emotionally-based illness serves to discredit asthma as a 'real' illness among health professionals and patients alike, contributes to the sense of stigma that persons who have asthma experience, and impedes effective management. Findings from research with a sample of 95 adults with physician diagnosed and documented asthma indicate that persons who have asthma walk a tightrope between delaying formal medical intervention and seeking treatment too soon. Uncertainty about the quality and speed of care available in an emergency department shapes, in part, the nature of the lived experience of asthma and affects feelings of control over the illness. These concerns create a push-pull dynamic, as individuals struggle to make decisions about emergency department use that will provide relief, ensure autonomy, deter the experience of stigma, and diminish the threat of death.

Adult↗
PubMed1993

Assessment and management of adults with asthma: guidelines for nurse practitioners.

Asthma is a potentially life-threatening chronic disease requiring consistent and careful management. NPs play a prominent role in diagnosing, managing, and teaching people with asthma. Understanding current theories of pathogenesis, principals of therapeutic management, and patient education is critical to reduce rising asthma morbidity and mortality. When the patient, family members, and the clinician work together in partnership, an optimal individualized treatment plan can be established.

Asthma↗
PubMed1992

Patients' perceptions of pulmonary problems and nursing interventions during hospitalization for Pneumocystis carinii pneumonia.

BACKGROUND AND METHODS: The descriptive, correlational study examined patients' perceptions of pulmonary problems and nursing interventions in a sample (n = 201) of persons living with AIDS hospitalized for Pneumocystis carinii. Additionally, the study assessed differences in physiological variables, patient symptoms, and functional status based on the type of problems identified: dyspnea, pulmonary problems without dyspnea, and nonpulmonary problems. RESULTS: A total of 601 problems was identified including 61 instances of dyspnea and 83 reports of other pulmonary problems. The remainder of the problems was nonpulmonary. Nursing interventions associated with dyspnea and pulmonary problems other than dyspnea were mainly broadly defined interventions such as oxygen and medication administration. When patients were placed into three groups based on identification of dyspnea, pulmonary problems without dyspnea, or only nonpulmonary problems, there were no differences between groups in functional status or patient symptoms of pain, nausea, or fatigue as measured by the Quality Audit Marker. CONCLUSIONS: This study demonstrated that hospitalized patients with Pneumocystis carinii present with a broad array of problems. Contrary to expectations, dyspnea was not ubiquitous but was reported by less than one-third of this sample. When dyspnea was present there were few independent nursing interventions that patients identified. Studies are needed to test effective strategies for the nursing management of dyspnea and a large variety of other patient problems associated with HIV infection.

AIDS-Related Opportunistic Infections↗
PubMed1992

Clinical markers of asthma severity and risk: importance of subjective as well as objective factors.

The purpose of this study was to explore patient perceptions of asthma severity and danger from asthma, correlate them with objective measures, and assess the impact of psychologic variables on the perception of severity. Recognition of patients at greatest risk for fatal attacks requires identifying those with severe asthma. In our study of 95 adults with asthma, we found that the subjective factors of perceived severity and perceived danger and the objective factors of medications, hospitalizations, history of intubation, and pulmonary function were important markers of asthma severity and risk. Our findings indicate that asthmatic adults make independent self-assessments that generally correlate with objective markers of increased risk of mortality and increased severity of the asthma. The perception of high severity was significantly correlated with depression, panic-fear, frequency of emergency department visits, and with an objective index of risk of death. The latter includes variables obtainable from history alone (number of medications to control symptoms, need for prednisone, prior intubation, and prior recent hospitalization) and is correlated with spirometric indexes of airflow obstruction, occurrence of nocturnal symptoms, and number of emergency department visits.

Adult↗
PubMed1988

Dyspnea in the ventilator-assisted patient.

Our purpose in this study was to investigate the factors coincident with the occurrence of dyspnea in ventilator-assisted patients. Five alert and oriented patients with pulmonary disease that was restrictive, obstructive, or both, who were receiving mechanical ventilation, participated in this descriptive study. At 4-hour intervals and at complaint of dyspnea, patients quantified the severity of their dyspnea using the visual analogue and modified Borg scales. At each measurement of dyspnea, nurses observed concomitant physiologic and environmental variables. A moderate correlation (r = 0.51, p less than 0.001) was found between the number of events and activities occurring in the intensive care unit environment and the occurrence and severity of dyspnea. The visual analogue scale and modified Borg scale measures of dyspnea were highly correlated (r = 0.92, p less than 0.001) and may be useful tools for assessing dyspnea in patients undergoing mechanical ventilation.

Adult↗
PubMed1988

Effect of peak flow information on patterns of self-care in adult asthma.

Self-care is an important issue in the management of adults with asthma. Little is known about the specific strategies used by people with asthma to control symptoms and abort asthma attacks. The purpose of this study was to identify self-care strategies used to control asthma symptoms and to determine the effect of peak expiratory flow rate (PEFR) information on selection of self-care strategies. Thirty adult subjects with asthma were randomly assigned to either a control or an experimental group; 28 completed the study. All subjects recorded episodes of dyspnea, wheezing, and chest tightness and self-care actions in an asthma symptom diary. The experimental group recorded PEFR at the beginning and end of each symptom episode. Reported strategies were categorized into problem-focused, emotion-focused, or mixed self-care strategies. The experimental group, with access to PEFR information, used medication significantly less often than the control group. The experimental group also reported fewer and less frequent uses of alternative nondrug strategies.

Adaptation, Psychological↗
PubMed1986

Emotionally triggered asthma as a predictor of airway response to suggestion.

Twenty-nine male and female adults with asthma were tested to determine the relationship between perceived response to emotional triggers of asthma and bronchoconstrictive suggestion. Subjects were told that they were inhaling a bronchoconstricting agent in four increasingly potent concentrations, when in fact the solution the subjects inhaled was nebulized isotonic saline. Ten subjects responded to suggestion with a greater than 20% increase in specific airway resistance, but this response could not be predicted by the report of perceived emotional triggers of asthma. The finding that perception of asthmatic response to emotional arousal does not predict airway response to bronchoconstrictive suggestion may mean that suggestion is an invalid proxy variable for studying the role of psychological factors in provocation of asthma.

Adult↗
PubMed1983

Defense mechanisms: protecting the healthy lung.

In addition to performing its primary function of gas exchange, the lung plays a critical role in defending the body against a hostile environment. The highly efficient nonspecific defense mechanisms help to preserve the lung structure and function. Specific immune mechanisms exist both systemically and locally. Activation of these latter responses may result in protection or in hypersensitivity. Failure of one or more components of the defense system of the lung may result in acute or chronic disease and may exacerbate or contribute to other concurrent illnesses.

Antibody Formation↗
PubMedDate not supplied

The sensation of pulmonary dyspnea in school-age children.

The purpose of this investigation was to describe the sensation of dyspnea in a sample of 39 school-age children with asthma and to identify strategies used to cope with the symptom. In addition, three methods to measure dyspnea intensity in children were tested and compared. Breathing on a "bad breathing day" was used as a proxy variable to represent dyspnea. The most frequent description of how breathing feels on a bad day was "it is hard to breathe." Words chosen most frequently from a checklist of sensations were "wheezy," "short of breath," "tight," and physical sensations such as "throwing up," "hurting," and "stuffiness." The children's feelings on a bad breathing day were categorized as negative moods or emotions, a wish for change, or physical symptoms. Ratings of breathing on "good", "bad," and "usual breathing" days on word descriptor, visual analogue, and color scales provided evidence of concurrent validity for the three measures of dyspnea intensity. The most frequent strategies used to cope with dyspnea were medications, change in position, decreased activity, fluids, relaxation, distraction, and social support. The findings were very similar to those previously described for an adult sample.

Adaptation, Psychological↗
PubMedDate not supplied

The sensations of pulmonary dyspnea.

This study compared recalled physical and emotional sensations during episodes of acute dyspnea across pulmonary disease groups. The convenience sample consisted of 68 subjects with emphysema-bronchitis, asthma, vascular, and restrictive disease. Temporal patterns of physical and emotional sensations before and during episodes of dyspnea were identified. The frequency of sensations was remarkably similar across disease categories with few significant differences identified. Rather than the disease category, the frequency, intensity, and periodicity of the symptom of dyspnea had the greatest effect on the quality and frequency of sensations reported. The intensity of usual dyspnea reported on a visual analog scale varied significantly among groups, p = .026, with asthmatics having the lowest mean score and vascular subjects the highest. Females reported significantly greater usual dyspnea than males, p = .005. The variables of pulmonary disease group, gender, fatigue, and total network of social support were significantly related to usual dyspnea, and pulmonary group, gender, and attendance at Better Breathers classes were significantly related to worst dyspnea.

Adult↗