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Biomedical subjects

S Robichaud-Ekstrand

Publications and source records attributed to S Robichaud-Ekstrand.

17 recordsLinked to original sources
PubMed1997

[Psychometric evaluation of an instrument measuring motivation].

McEwen's Health Motivation Assessment Inventory (HMAI) (1993) tool was developed to assess the motivation of patients with coronary artery disease to initiate and sustain healthy habits. Because of its measurement difficulties, it was modified and translated into French. The purpose of this methodological study was to examine the psychometric properties (content validity, internal consistency, and test-retest reliability) of the modified HMAI on 255 normal subjects. The average proportions of the items, rated congruent by the three raters, were 0.99 for clarity and 0.95 for relevancy. The final Cronbach's alpha coefficients for the six subscales ranged from 0.08 to 0.67. Confirmatory factor analysis provided evidence that the majority of the items were moderately independent of each other. Also, temporal stability coefficients ranged from 0.49 to 0.81. Finally, the modified HMAI was found to be free of social desirability bias. Although the modified HMAI appears to be a promising tool for future research, further refinement is needed to improve its validity.

Bias↗
PubMed1996

[Exercises that should be prescribed for heart patients].

The goal of cardiac rehabilitation is to assist the patient in regaining, as close as possible, normal functioning. Participation in an exercise program is one way to achieve this objective. Exercise improves not only the physiologic state of the patient, but also produces many psychosocial benefits. However, exercise prescription is different for cardiac patients, according to the factors associated with the type of cardiac pathology and the surgical intervention. The goal of this article is to inform and guide the nurse in prescribing exercise for cardiac patients. A case study of a patient with cardiac pathologies such as angina, myocardial infarction, and congestive heart failure is presented. The nurse will learn how to prescribe the appropriate types of activities as well as the intensity, duration and frequency of the training sessions. The nurse will also be able to recommend appropriate physical activities for phase II of cardiac rehabilitation, a phase embracing the time from hospital discharge through the following three months. Finally, a list of activities and hobbies, with various energy costs, is presented.

Exercise Therapy↗
PubMed1995

[How to intervene effectively with a dying patient].

Nurses are in a strategic position to meet the needs of the dying patient. However, when confronted with death, nurses often utilize avoidance behaviors, such as: tending to the dying patient only if a technique is required; initiating conversations on casual topics or directing the conversation towards the patient's "health"; requesting consults to avoid talking about dying; and unnecessarily overmedicating the patient. This paper explains the rights and needs of the dying patient and describes associated nursing interventions. For example, the dying patient has the primordial right to choose whether or not to receive treatment. For nurses to intervene effectively, they must learn to manage their own emotions relating to death. A strong theoretical understanding of the dying process must be acquired. They must also develop internal strengths and receive help from various resources. By doing so, nurses reinvest their shared life experiences and apply them to other dying patients continuously refining their conceptual model of loss. Through verbal and non-verbal cues, nurses transmit profound messages to their patients. Some efficient nursing interventions consist of: providing basic care and medications to prevent terminal suffering; offering an attentive and reassuring presence; respecting the contemplative phases; listening for latent messages in conversations; understanding symbolic language; respecting family dynamics; allowing family members to choose physical and psychosocial interventions to improve the patient's comfort; frequently visiting the patient and intensifying their presence; permitting the dying patient to verbalize fears and anxieties; and consistently offering tenderness, empathy, acceptance, warmth and respect. As death nears, scientific and technological aspects of nursing become less important for the patient, and the art of sincere human empathy becomes paramount.

Attitude of Health Personnel↗
PubMed1995

[New approach for defibrillation after cardiac reoperation].

Cardiac reoperations are associated with several complications such as ventricular lacerations, major vessel trauma, and ventricular arrhythmias. As it is impossible to defibrillate before ending the pericardial dissection, this latter complication increases the mortality rate in the perioperative period. In those instances, the self-adhesive electrode pads for external defibrillation were proven effective for cardioversion and defibrillation, even in the presence of adherences. In our institution, these electrode pads are compulsory for all patients requiring cardiac reoperation. The apex pad covers the cardiac apex in the V5 and V6 electrode derivations, while the posterior pad is placed over the right infrascapular area, which reduces the risk of hazardous current concentration. In addition, it does not obstruct the operative site and the pads can be connected to a R2 cable adaptor compatible with regular leading defibrillating systems. The electrode pads were tested on 132 of the 508 patients (26%) requiring cardiac surgery during a 6-month period. Eighteen of these cases (14%) required one or more defibrillating during the operation. The benefits of using this system (R2 Corporation, Skokie, Ill) include: a smaller dissection, reduced blood loss, lower numbers of blood transfusions, and decreased operating time. When the electrode pads remain in place during the patient's transfer to the intensive care unit and the first hours thereafter, they can be used again this time to control arrhythmia complications after the surgery.

Cardiac Surgical Procedures↗
PubMed1994

[A method for validating a translated questionnaire].

This paper describes Haccoun's (1987) technique for validating a translated questionnaire. This method is based on the idea that if a questionnaire is well translated, bilingual subjects will provide equivalent responses to questions in either language. A single group of bilingual subjects is given both language versions of the questionnaires at two different times in random order. Subsequently: 1) test-retest reliability coefficients are computed for the original and translated versions; 2) correlation coefficients between the original and translated versions of the instrument are computed and compared (simultaneous correlations between languages); 3) the correlations between the original version at time 1 and the translated version at time 2 and vice versa are computed and compared (cross-correlations); and 4) the cross-correlations are compared to the test-retest reliabilities within each language. The final step indicates whether the translated version of the instrument is equivalent to the original. The authors use Haccoun's technique to demonstrate that a French translated version of Alcock et al.'s (1990) questionnaire on nurses' perceptions of nursing research is reliable and statistically equivalent to the original.

Nursing Research↗
PubMed1994

Cardiac nurses' perceptions of nursing research.

Nurses' perception of nursing research is an important variable affecting the successful development of a clinical nursing research program. The objectives of this study were to: examine the perceived value, role, interest, support and experience of cardiac nurses in nursing research; to determine the effects of age and level of education on their perceptions; and to analyze the reliability of Alcock et al.'s questionnaire. The survey was administered to 313 nurses with a response rate of 46%. Frequency distributions were obtained on individual survey items. MANOVAs were performed as a function of age group and education level, followed by post hoc ANOVAs. Findings showed nurses valued nursing research particularly as it related to clinical practice decisions and solutions to patient care problems. They saw a participatory role in the first stages of the research process. Age was not a factor in nurses' perceptions of nursing research with the exception of perceived support. Diploma nurses indicated higher levels of perceived value (p = 0.000), role (p = 0.034), interest (p = 0.000) and support (p = 0.017) for nursing research than baccalaureate nurses. The Cronbach reliability coefficient of each area indicated high internal consistency (> 0.72). When 5 items in the questionnaire are deleted, the tool exhibits high level of reliability and evidence of construct and discriminant validity.

Adult↗
PubMed1994

[Implantation of an internal defibrillator].

The article, part one of two in this issue, enables the nurse to follow a patient who receives an implantable defibrillator after surviving sudden cardiac death. Sudden cardiac death, which claims approximately 400,000 lives annually in the United States, is defined as natural, unexpected death due to cardiac causes, preceded by abrupt loss of consciousness within one hour of the onset of acute symptoms. It is generally caused by a complex interaction between a functional heart abnormality (such as ischemia) and an anatomic substrate (such as the myocardial scar tissue). Ventricular dysrrhythmias account for the majority of sudden cardiac deaths. This condition is treated with pharmaceutical antiarrhythmic agents or by implanting an internal cardioverter defibrillator. The equipment and surgery using the transvenous approach are described here. Specific nursing care during the postoperative period is also explained. Finally, the authors present several recommendations related to the convalescent period at home.

Defibrillators, Implantable↗
PubMed1994

[Psychosocial needs of patients carrying an implantable defibrillator].

Implantable defibrillators have created a new cardiac population. But with that population come particular needs. Eighty-five per cent of patients with implantable defibrillators experience significant fears and worries. Many of them fear the first shock or worry about the device's reliability. Others wonder if they will be able to remain in their current occupation. Despite these worries and others, 60 per cent of patients state being satisfied with the device. On the other hand, 53 per cent of these patients' spouses still fear the defibrillators. The authors of this article underline that nurses must learn to intervene appropriately to meet their patients' physical, learning and psychosocial needs. The nurse's responsibilities are to help patients identify their social support system and mobilize their resources, and to help family members in meeting patients' needs.

Defibrillators, Implantable↗
PubMed1993

[Clinical factors which influence the 1-year post-infarction prognosis].

Many clinical factors influence the 1-year prognosis in myocardial infarction (MI) patients. The most important clinical determinants are the left ventricular dysfunction, myocardial ischemia, and complex ventricular arrhythmias. Some authors have found an independent prognostic value of complex ventricular arrhythmias, while others consider that ventricular arrhythmias predict future cardiac events only if associated with low ejection fractions. Other factors that have 1-year prognostic value are the following: a previous MI, a history of angina at least 3 months preceding the infarct, postmyocardial angina, and the criteria that indicate to the practitioner whether MI patients are medically ineligible for stress testing. There still remain controversies in regard to the predictive value of certain variables such as the site, type, and extension of the MI, the presence of complex ventricular arrhythmias, exercise-induced hypotension, ST segment elevation, and the electrical provocation of dangerous arrhythmias.

Diagnostic Imaging↗
PubMed1993

[Nursing research].

Research in the health sciences is a continuously evolving activity. Nursing research, however, is unfamiliar to many health professionals. Even nurses are sometimes uncomfortable with this activity. The goal of this article is to demystify nursing research. The authors define nursing and nursing research, its goals, history and the actual state of nursing research in Canada.

Canada↗
PubMed1993

[Removing a femoral catheter].

Nurses at the University of Ottawa Heart Institute are removing femoral sheaths on post-angioplasty patients. The authors describe this new technique and explain how nurses can benefit by doing it. They discuss practical considerations before delegating this sanctioned medical act to nurses. Prevention and management of complications are also discussed as are research projects to evaluate the technique.

Angioplasty, Balloon, Coronary↗
PubMed1992

[The anti-depressive effects of post-infarct exercises].

Twenty-nine per cent of patients hospitalized following their first myocardial infarction (MI) are depressed. This percentage decreases with time to 15 per cent at six weeks, and fluctuates between 10 and 13 per cent at three and six months post-MI, respectively. This literature review indicates that exercise training programs are not the treatment of choice to reduce severe post-MI depression. However, in moderately depressed MI patients, their sense of humor is improved, especially if the exercise component involves some degree of socialization and counselling. The lack of significant findings may be compounded by other factors such as incorporating other life-style modifications, the patients' expectations and self-efficacy, and the type of measurement utilized to detect changes in depression levels over time. The type of depression scale used in most studies, the Minnesota Multiphasic Personality Inventory (MMPI), may also be incorrect for MI patients, since the etiology of post-MI depression varies from minor depression to a major depressive episode. The MMPI was developed for use with persons with psychiatric illness. Post-MI depression is considered a normal "uncomplicated bereavement" for the majority of patients. The optimal method used to identify post-MI depression following hospitalization seems to be observation and interview. This is essential to pinpoint the symptoms characteristic of uncomplicated bereavement.

Depressive Disorder↗
PubMed1991

Shower versus sink bath: evaluation of heart rate, blood pressure, and subjective response of the patient with myocardial infarction.

The purpose of this study was to compare the effects of a sitting shower versus a sitting sink bath in low-risk patients with myocardial infarction (MI). Heart rate, blood pressure (mean blood pressure and rate-pressure-product), ratings of perceived exertion, and occurrence of symptoms during the baths and between resting, bathing, and recovery periods were evaluated. Thirty patients with MI were tested during their first and second self-bath on 2 consecutive days between 2 and 9 days after MI. The bathing methods produced significant increases from the resting values in all the variables (p less than or equal to 0.05). No significant differences between the resting and recovery values existed (p greater than 0.05). Ten subjects experienced atypical responses to bathing as indicated by heart rate and blood pressures. Fatigue was the most frequently encountered symptom at rest and during the bathing activities. The findings suggest that low-risk patients with MI can choose between a sitting sink bath or a sitting shower as their first self-bath after MI, based on preferences. However, because the bathing activity (and not the bathing method) did produce some atypical responses in one third of the subjects, readiness to engage in bathing activities should be individually assessed by objective and subjective criteria.

Baths↗
PubMed1990

[Interpretation of blood gas analysis].

Acid-base problems can be easily identified by the nurse when a systematic approach is utilized during arterial blood gases interpretation. Furthermore, understanding the underlying principles of acid-base balance assist the nurse in choosing the appropriate intervention. By intervening early, many emergency situations can be avoided. Since the nurse is the primary care giver, and is most readily available for the client, early interventions to correct acid-base problems would expedite the client's recovery. This article demonstrates how to identify and explain acid-base problems by answering four key questions. Tables and figures are incorporated to facilitate understanding, and to summarize information in a succinct manner.

Acid-Base Imbalance↗
PubMed1990

[Orem in medical-surgical practice].

The Orem self-care model is directed towards maintaining the integrity of the human structure through regulating its function and development. In this article, Orem theory is applied to Louis, a 68-year-old man suffering from multiple sclerosis, admitted to a medical-surgical ward as a result of urinary retention. Answers are given to why Louis requires nursing care; what are his self-care practices and requirements; and how to determine his self-care deficits and translate them into nursing diagnosis.

Aged↗
PubMed1989

[The Neuman model in medical-surgical settings].

More and more teaching institutions and hospitals are integrating conceptual frameworks into nursing practice. This article describes how the Neuman theory can be applied in a medical-surgical setting. Strengths and perceived stressors are identified using selected, preformulated questions; they are further classified as intra-, inter-, or extra-personal factors affecting the holistic system of the person and the environment. A case study demonstrates how interventions can be applied at primary, secondary and tertiary levels.

Combined Modality Therapy↗