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Biomedical subjects

S T Fitzgerald

Publications and source records attributed to S T Fitzgerald.

15 recordsLinked to original sources
PubMed2000

Urinary incontinence. Impact on working women.

Until recently, the impact of urinary incontinence (UI) on working women, a population generally characterized as healthy, has not been the focus of research. Women employed full time at a large university center participated in a cross sectional survey about UI. Of the 1,113 women surveyed, age 18 and older, 21% (n = 232) reported UI at least monthly. Incontinent women were significantly older and had a higher body mass index than continent women. Using disposable products, limiting fluids, avoiding caffeinated beverages, using voiding schedules, and keeping extra clothes or underwear were strategies used to manage UI at work. Responses to an open ended question related to the impact of UI on working life included: interference with sleep and resulting fatigue at work, embarrassment, alteration of concentration, and emotional distress. Implications for nurses are discussed in relation to assessment, education, and management of UI in the occupational setting.

Adaptation, Psychological↗
PubMed1996

Diagnosis and management of asthma: occupational health nurses' awareness and use of national consensus practice guidelines.

A regional sample of members of the American Association of Occupational Health Nurses (AAOHN) from Maryland, Delaware, Virginia, and the District of Columbia was surveyed prior to the publication of the Expert Panel Report on Guidelines for the Diagnosis and Management of Asthma (time 1). The guidelines were disseminated directly to AAOHN members through an article in AAOHN Journal and an annual convention plenary session presentation at which copies of the Report were distributed. They were disseminated indirectly through medical journals and government documents. A follow up survey of AAOHN members' familiarity with and use of the Expert Panel Report was conducted 1 year later (time 2). Of the total eligible sample of 570 persons, 325 (57.0%) responded at time 1. Of these, 232 (71.4%) responded at time 2. One year after publication, 31 (13.4%) of the nurses participating in the time 2 survey were aware of the Report, 16 (6.9%) reported having an available copy of the Report, 31 (13.4%) were familiar with the recommendations in the Report, 17 (7.3%) referred to the guidelines and 34 (14.7%) based care on the guidelines. Multiple direct dissemination strategies of consensus guidelines to improve practice will be necessary if nurses' awareness and use are to be enhanced.

Asthma↗
PubMed1995

Adolescents and work: risks and benefits of teenage employment.

1. Adolescent employment, both legal and illegal, has been on the increase in the U.S. during the past 2 decades. According to the U.S. Department of Labor, more than 5.9 million children between the ages of 16 and 19 were legally employed in May 1994. 2. Benefits of employment include self reliance and discipline, improved organizational skills, and financial management as well as a sense of responsibility, teamwork, and exposure to occupational choices. 3. Negative effects of employment include threats to completion of developmental tasks and education, injury, toxic exposure, and illness.

Adolescent↗
PubMed1994

Direct and indirect cost of percutaneous transluminal coronary angioplasty.

A prospective study of 53 patients employed in the 6-month period before coronary angioplasty was performed to determine the direct and indirect costs of lag time in work resumption. The total direct costs calculated were $273,480; indirect costs for this sample were $150,944. When these costs are generalized to all patients in the US undergoing uncomplicated percutaneous transluminal coronary angioplasty, the costs are more than $1.2 billion. This study demonstrated that even in patients with a high a priori probability of work return, delay in work resumption results in a greater cost to the individual and society through absence from the labor force.

Adult↗
PubMed1992

National Asthma Education Program Expert Panel report: guidelines for the diagnosis and management of asthma.

1. Asthma, a chronic lung disease that affects 10 million Americans, is receiving increased attention as a public health problem due to increased occurrence and number of reported deaths. 2. This article presents an overview of the National Asthma Education Program Expert Panel guidelines, specifically addressing the definition and pathophysiology of asthma, effective management and control of asthma, and special considerations in asthma management. 3. Implications of the Expert Panel guidelines for occupational health nurses are addressed.

Asthma↗
PubMed1991

Self-Efficacy Theory. Implications for the occupational health nurse.

1. Self-efficacy, a concept derived from Social Learning Theory, provides a theoretical framework for behavior change. This framework can be used by the occupational health nurse to develop programs designed to effect behavior change. 2. Research studies focusing on behavior change (e.g., smoking cessation, weight control, exercise and cardiac rehabilitation, work resumption) employing the concept of self-efficacy are reviewed. 3. Self-efficacy predicts modification and maintenance of behavior.

Health Behavior↗
PubMed1990

Functional status after coronary artery bypass grafting and percutaneous transluminal coronary angioplasty.

Two cohorts of consecutive patients of comparable age with similar preprocedure cardiac function who underwent either coronary artery bypass grafting (CABG; n = 106) or percutaneous transluminal coronary angioplasty (PTCA; n = 64) were entered into a prospective comparison study examining functional status and return to work during the first year of recovery. Patients were evaluated using standardized functional status instruments for activities of daily living, work performance, social activity, mental health and quality of social interaction at 1, 6 and 12 months after the procedure. Within the CABG group, statistically significant improvements of functional status on every subscale were noted over the 1-year follow-up. Patients undergoing PTCA demonstrated significant improvement in all dimensions except for the quality of interaction at 1 year as compared with baseline. When the 2 groups were compared, the PTCA group demonstrated greater participation than the CABG group in routine daily physical and social activities at 1 and 6 months, but this apparent advantage disappeared by 1 year. Measures of psychological functioning were better after CABG than after PTCA. A reduction in the number of those with employment occurred in both the CABG and PTCA groups, independent of physical functional status measures, which improved in both groups after the procedures. For those with employment, the CABG group reported the greatest improvement in work performance.

Activities of Daily Living↗
PubMed1989

Return to work after percutaneous transluminal coronary angioplasty.

A prospective study of 82 patients employed in the 6-month period before percutaneous transluminal coronary angioplasty (PTCA) was performed to determine the patterns of lag time in work resumption and the factors associated with early return to work. One month after PTCA, 59% of patients had resumed work whereas 87% were employed 6 months after PTCA. Patients who had a myocardial infarction in the month before PTCA, as well as those with less than 12 years of education, blue collar jobs and low levels of self-efficacy (self-confidence) for return to work had a lower probability of work resumption at every point in the 24 weeks of follow-up. Cox proportional hazards analysis revealed the psychosocial construct, self-efficacy, to be the strongest predictor of return to work 1 month after PTCA, independent of having a recent myocardial infarction, disease severity, age, job classification, gender and physician advice (p = 0.0006). Kaplan-Meier analysis for return to work after PTCA confirmed that patients with high self-efficacy estimates obtained just before hospital discharge after PTCA resumed employment earlier than those with low self-efficacy levels (p = 0.0001). The same relation was observed in those patients with and without a myocardial infarction in the month before PTCA, p = 0.0022 and 0.0012 respectively. These findings suggest that although PTCA is considered relatively safe and minimally invasive by physicians, patients may still lack confidence in their ability to return to work even when physically capable of doing so.

Absenteeism↗
PubMedDate not supplied

Factors related to functional status after percutaneous transluminal coronary angioplasty.

OBJECTIVE: To describe the recovery process 1 year after percutaneous transluminal coronary angioplasty (PTCA) and measure factors that influence functional status. DESIGN: Prospective, one-group observational study. SETTING: Mid-Atlantic, university-affiliated, tertiary care medical center. PATIENTS: One hundred thirty-five adults who underwent first-time PTCA. The age range was 29 to 78 years (mean 57). OUTCOME MEASURE: Functional status. INTERVENTION: Data collection was initiated before PTCA by personal interview and self-administered questionnaire conducted in the hospital and 12 months after PTCA by mailed questionnaire. Data on clinical, demographic, occupational, and psychosocial factors were collected to determine the predictors of functional status 12 months after PTCA. RESULTS: One-tailed paired t tests were conducted to measure whether there was improvement (positive change) in functional status from before PTCA to 12 months after PTCA. Multivariate and logistic-regression analyses were also conducted. Although there were significant improvements in functional status outcomes in the categories of activities of daily living, mental health, and social interaction 12 months after PTCA, patients continued to report important functional status disabilities in the categories of activities of daily living (14%), social activity (14%), mental health (25%), quality of interaction (10%), and work performance (17%). The variable most predictive of functional status was the patient's baseline score on that particular functional status subscale. CONCLUSION: These findings are consistent with other studies on functional status. They suggest that rehabilitation programs should assess pre-PTCA functional status to identify those individuals at risk for poor outcome after PTCA and design interventions to restore physical and functional status after PTCA.

Activities of Daily Living↗
PubMedDate not supplied

Incontinence in a manufacturing setting: women's perceptions and responses.

The true prevalence of urinary incontinence (UI) and its impact on the quality of life in working women are not well established. Many women do not report UI to a health care provider because they mistakenly believe UI is a natural part of aging. This situation exists despite the dissemination of a national guideline for UI in adults. The aims of this study were to (1) explore what incontinent women in a manufacturing setting name or identify as the proposed cause of urinary leakage (2) analyze an association between identifying a UI cause and reporting it to a health care provider and (3) determine how many women were aware of the AHCPR Guideline. The results indicate that the majority of incontinent women (62%) have not reported this to a health care provider. Most women attributed urinary leakage to parity and waiting too long to empty the bladder. There was no relationship between identifying a UI cause and reporting it to a health care provider. Only 2 of the women out of 78 had heard of the AHCPR Guideline but the majority of women wanted more information about UI (85%). Mechanisms are suggested for querying women with UI and disseminating the AHCPR Guideline.

Adolescent↗
PubMedDate not supplied

Evaluation of referral completion after a workplace cholesterol screening program.

We designed a randomized clinical trial to examine effectiveness of a follow-up educational mailing to improve referral completion following a workplace cholesterol screening program. Of 836 employees who participated in a cholesterol screening program at Blue Cross and Blue Shield of Maryland, 313 (37%) had a total cholesterol greater than or equal to 200 mg/dL and were referred to their physician for remeasurement and evaluation. Individuals with elevated cholesterol who agreed to a telephone interview two months after screening (n = 272) were randomized to a control or intervention group. The intervention consisted of a booster mailing two weeks after screening designed to encourage further physician follow-up and to increase knowledge about cholesterol and its dietary control and about risk factors for coronary heart disease (CHD). No statistically significant differences appeared between the control and intervention groups in rate of referral completion. However, a blood cholesterol level of greater than or equal to 240 mg/dL at the time of screening was the most significant predictor of referral completion (P less than .0001). Of those randomized, the association between the number of other additional risk factors for CHD and referral completion was not statistically significant. There was, however, a trend toward reported changes in lifestyle behavior as a result of screening, particularly in diet modification.

Adult↗
PubMedDate not supplied

Role of the employee assistance program in helping the troubled worker.

The worksite has been identified as the most logical setting for providing primary preventive health care efforts that will reduce health care costs. Hazeldon Research Services in their review entitled, "The Cost-Impact of Employee Assistance and Chemical Dependency Treatment Programs," concluded that a significant savings for organizations has been demonstrated by EAP treatment programs. This group also concluded that work remains for service providers, the community, industry, and government to identify the balance between reasonable costs and quality of care. Roman has found that EAPs are becoming more acceptable to management as a means of addressing a broad range of employee problems. In addition, Roman has found that there is recognition by management that many employees have problems that affect job performance. Such problems may include substance abuse, relationship difficulties, absenteeism, and burnout. EAP services have evolved from occupational alcoholism programs to include a broad array of services, and they can be scaled to fit the size and needs of a particular company. Even if only limited services are offered, the EAP must adhere to high standards. Competent employee evaluation and appropriate referrals are necessary in EAPs with even the smallest of scopes.

Alcoholism↗