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Biomedical subjects

T Krulik

Publications and source records attributed to T Krulik.

18 recordsLinked to original sources
PubMed2001

Emotional and physical demands on caregivers in home care to the elderly in Switzerland and their relationship to nursing home admission.

BACKGROUND: Planning the home care of growing numbers of old, dependent people must include the caregivers' burden. METHODS: A convenience sample of 129 caregivers of elderly patients with multiple diagnoses was interviewed about the caregiving context, burden, caregivers' tolerance of patients' troublesome behaviours and physical symptoms, mutuality and feelings of closeness between caregiver and patient. Continued maintenance of home care was assessed by a follow-up telephone call. RESULTS: Caregivers were mainly spouses (67%) and female (73%), and the mean duration of care was 5.5 years. In five activities of daily living (ADL) 50-69% of the patients needed full help. Caregivers reported predominantly negative effects of caregiving on their physical and mental health, rest and sleep, leisure time and social life, problems with patients' symptoms and behaviours and little or no conversing (51%) or exchanging feelings with patients (71%). PREDICTIVE MODELS: Contributors to variance were for burden (35%), impact of care on caregivers' mental health, social relations and leisure time, patients' gender, accumulation of patients' symptoms and behaviours; for caregivers' tolerance toward patients' symptoms and behaviours (17%) caregivers' physical health, patients' level of confusion, feelings of mutuality; for mutuality (22%) and for closeness (19%) caregivers' mental health, patients' accumulation of symptoms and behaviours. Within 23 months 19% of the patients had been institutionalized. Factors giving a higher likelihood of institutionalization were: being male, caregiver was not a partner, and less closeness between caregiver and patient. CONCLUSION: Caregiving of older persons has bio-psychosocial ramifications for caregivers. Closeness between caregiver and patient seems to be a key factor in determination of the long-term outcome.

Activities of Daily Living↗
PubMed2000

Self-efficacy and physical activity in adolescents with trivial, mild, or moderate congenital cardiac malformations.

Our purpose was to examine the cognitive processes that influence involvement in physical activity among 100 adolescents, 55 boys and 45 girls, ranging in age from 12 to 18 years, with trivial, mild, or moderate forms of congenital cardiac disease. We hypothesized, first, that the severity of the congenital cardiac malformation itself has an indirect effect on self-efficacy regarding physical activity, and that the relationship between the two is mediated by the recommendations of the cardiologist and the attitude of the mother. Second, we argued that self-efficacy serves as a mediating variable between the recommendations of the cardiologist and the attitude of the mother, on the one hand, and involvement in physical activity, on the other. The results confirmed both hypotheses. In a population of adolescents with trivial to moderate congenital cardiac malformations, beliefs in self-efficacy, rather than severity of the disease, were the most influential factors in determining whether or not adolescents will engage in sports or other physical activities. We also demonstrated the importance of the role played by the recommendations of the cardiologist in determining both the attitudes of the mother and the belief in self-efficacy of the adolescents.

Adolescent↗
PubMed1999

A test of parenthood: dilemmas of parents of terminally ill adolescents.

This article presents partial findings from a study that examined the process experienced by parents (mainly mothers) of an adolescent child with terminal cancer. It focuses on two processes that characterize the parents' social world: a crisis in the parental role and a departure from the normative life cycle. These processes, and the parents' coping with them, were studied from the perspective of time and time management. One of the study's claims was that the terminal disease alters the definition of parenthood and causes the parents to depart from the normative life cycle. The study's purpose was to find and explain the coping patterns used by the parents of terminally ill adolescents. This article focuses on two of the various side effects discovered: the distortion of the subjects' time world and the test of parenthood.

Adaptation, Psychological↗
PubMed1998

Measuring impact of nursing intervention on cancer patients' ability to control symptoms.

Cancer patients' ability to control symptoms and to maintain reasonable quality of life is limited due to lack of knowledge, guidance, and instructions from health care providers, who usually refrain from transferring responsibility for the treatment to the patient. The present study describes a measured effect of a structured nursing intervention in which nurses were trained to apply the self-care model to 48 ambulatory cancer patients under chemo- or radiotherapy or both. The intervention included 10 structured home visits to each patient during 3 months, in which the nurse assessed symptoms and advised, guided, supported, and educated the patient in the relevant areas. The symptoms were quantitatively assessed using the Symptom Control Assessment (SCA) instrument, which was developed and validated specifically for this study. The SCA relates to 16 signs, symptoms, and complaints that encompass both the universal and the deviation-from-health needs, in addition to anxiety, body image, and sexuality. The instrument allows either the patient or the nurse to rate the severity of the complaint, the patient's independence in controlling it, the patient's perception of the familial and external help extended to him or her, and the knowledge of the symptom and its control possessed by the patient. Also, the SCA allows comparing the patient's ratings with the professional view of the visiting nurse. The SCA was proven to be a highly reliable and valid instrument. The results indicate that the intensity of the complaints decreased in the experimental group during the 3-month period while they increased in the matched control group, creating a considerable difference between the two groups on multivariate analysis of covariance (MANCOVA). On t-tests, significant improvement was found in 15 out of the 16 symptoms, including pain. The greatest reduction was found in the "psychosocial symptoms," namely anxiety, sociability, body image, and sexuality. Similarly, the patients' independence, knowledge, and perception of familial help increased in the experimental group and declined in the control group. Perhaps the most meaningful change was a significant increase in the ability of the experimental patients to assume responsibility for their own treatment as it is reflected by the increase of the independence ratings for all 16 symptoms. This is in sharp contrast to the decrease in 15 of the 16 symptoms among control patients. The results suggest that the self-care approach is effective also in improving the quality of life for unstable cancer patients by reduction of suffering and increase in controlling capabilities.

Adult↗
PubMed1991

Loneliness and social support of mothers of chronically ill children.

To address the problem of loneliness and social support in mothers of chronically ill children, we interviewed 90 mothers, among them 33 whose children suffered from a chronic life-threatening disease and 57 whose children had a chronic illness. In addition, we conducted home interviews with a control group of 92 mothers of healthy children. In responding to questions on the revised UCLA Loneliness Scale and the Norbeck Social Support Questionnaire, the mothers of children with either chronic life-threatening or chronic illness revealed higher loneliness than the mothers of healthy children. Larger social networks and perceived greater support was reported by mothers whose children had a chronic life-threatening disease. In this group, no significant relationship was found between the variables of loneliness and social support; whereas, in the group with chronically ill children, and in the controls, a significant inverse relationship between the two variables was noted. Mothers of children with chronic life-threatening diseases may become subject to higher existential loneliness.

Adaptation, Psychological↗
PubMed1991

Nationwide faculty development: a model for a shift from diploma to baccalaureate education.

Many countries are in the process of moving nursing education from 2-year or 3-year diploma programmes to institutions of higher education. This paper reports on a national project in Israel in which diploma school faculties were retooled for baccalaureate teaching. Among many issues associated with this shift are two addressed by this paper: what are the essential differences between diploma and baccalaureate education and how can faculty be developed so that the change is substantive and not the same type of education with a different label? The authors propose: (a) more radical changes must occur in the preparation of faculty for there to be substantive differences in the graduates; (b) the objectives curriculum model widely exported from the USA promotes training for technical levels of nursing and inhibits true education for professional practice; (c) there are six types of learning, not one, and the difference between technical and professional nursing education lies in the types of learning emphasized by faculty.

Curriculum↗
PubMed1980

Successful 'normalizing' tactics of parents of chronically-ill children.

To be or to parent a chronically-ill child is a difficult experience. Parents can initiate 'normalizing' tactics that alleviate the child's feeling of being different and enable a sense of control with the possibility to influence the quality of life of the child and the family. Following up among 20 parents of chronically-ill children, the author was able to identify a number of principles which underlined the 'normalizing' tactics. These principles, it is suggested, should be helpful to nurses and other health workers when guiding and advising parents and others who come into daily contact with chronically-ill children.

Child↗
PubMedDate not supplied

The continuation of home care to severely impaired children and aged in Israel: family attitudes.

There are a growing number of children and aged with severe chronic health problems in the community. Mothers become the prime caregivers to these children and aging spouses or middle-aged offspring the caregivers to these aged. The services offered to these families are determined by economic and social conditions, as well as changing fashions, rather than knowledge of the patients' and caregivers' needs. The purpose of this study was to assess the impact of homecare upon families caring for children versus those caring for aged and these families' attitudes toward continuation of home care versus institutionalization. The families included in the study were drawn randomly from the case load of community nurses in central Israel. In-depth interviews were conducted with 92 families of severely impaired children and 181 families of severely impaired adults and aged in their homes. While the majority of both populations carry a heavy burden of caregiving over years, they also receive gratification from their ability to care for their patient at home. There is little difference between those caring for children and those caring for adults in their attitudes toward continuation of home care. Mental rather than physical impairment, a deteriorating illness trajectory; depression, aggression and tension of the caregiver, the absence of sufficient social support and home care services correspond with negative feelings toward continued home care. The perceived impact of caregiving responsibilities upon the caregivers' lives, the ability to tolerate and manage symptoms and above all the quality of the patient-caregiver relationship influenced the caregivers' attitudes toward institutionalization in both populations. Family attitude toward continued homecare and institutionalization of children and adults are compared and the needs for services discussed.

Aged↗
PubMedDate not supplied

Small groups in Israeli education programmes.

Small groups have been used extensively in a broad range of circumstances with various populations and vastly differing goals. This Israeli study explored the contribution made through the participation of public health nurses in a small-group supervisory experience, which was an adjunct to a theoretical and clinical learning programme aimed at preparing the nurses for intervention in families with a chronically ill child. The impact of participation in supervised small groups, as perceived by the nurses, is assessed and evaluated.

Child↗