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At least 703 records · Page 39Linked to original sources
PubMed1998

Medical student knowledge of morphine for the management of cancer pain.

Inadequate training of physicians contributes to the undertreatment of cancer pain. To address these concerns, the University of Kentucky has introduced a 4-week course for final-year medical students that teaches the principles of clinical pharmacology and pain management. The purposes of this study are to assess the knowledge deficits of final-year medical students about the use of morphine for cancer pain and to assess the efficacy of a short course on cancer pain management. Eighty-six final-year medical students completed a 22-item questionnaire assessing their knowledge and attitudes toward the use of morphine for cancer pain. Students indicated their agreement with each statement on a four-point scale (one, strongly disagree; four, strongly agree). All students then completed a compulsory short course on pain management. The course content included a 1-hr lecture on chronic nonmalignant pain, a 1-hr lecture on acute pain management, and a 1-hr lecture on cancer pain management. In addition, students completed small-group, problem-based learning modules on several aspects of pain management. After the course, all students completed the same 22-item survey. The alpha reliability score of the pretest instrument was 0.55, and the posttest reliability was 0.86. Upon course completion, students agreed most strongly (mean +/- SEM) that morphine should be given on a regular schedule for cancer pain (3.41 +/- 0.08), that cancer pain management frequently requires co-analgesics (3.36 +/- 0.06), and that patients with good pain relief function better than those with continuing pain (3.39 +/- 0.08). A comparison of pretest and posttest means on specific items suggested that the greatest amount of learning took place in the following content areas: morphine is a good oral analgesic; increases in cancer pain should be treated by increasing the morphine dose; respiratory depression is not a concern for cancer pain patients; and morphine can be used over a wide range of doses. The regular use of morphine was recognized as the treatment drug of choice for cancer pain. The students showed improved knowledge scores on ten of the 22 items on the posttest survey. A significant increase in learning occurred on six knowledge and attitude items. On only one item (nausea as a side effect of morphine) did the knowledge scores decrease on the posttest. A significant minority (40%) of senior medical students had deficits in knowledge about the use of morphine for cancer pain. The risk of addiction, respiratory depression, and tolerance were misunderstood by a significant minority (25%) of students.

Analgesics, Opioid↗
PubMed2006

Proposing a roadmap for HealthGrids.

With the regular progress of technology and infrastructures, a growing number of grid applications are developed and deployed for life science and medical research. At the last HealthGrid conference in April 2005 in Oxford, many groups described successful usage of grids for compute intensive calculations. Very large scale deployment of a biomedical application in the area of drug discovery has been achieved on EGEE during 2005. On the other hand, beside a few pioneers, very few data grids have been deployed so far and knowledge grids are still at a conceptual level. This situation is expected to evolve quickly as many projects are focussed on developing data management services and knowledge management tools relevant to biomedical sciences. At this stage, it is important to identify the potential bottlenecks and to define a roadmap for the wide adoption of grids for healthcare. This article presents an analysis of the present adoption of grids for biomedical sciences and healthcare in Europe: it identifies bottlenecks and proposes actions that will be further assessed within the framework of the SHARE European project dedicated to the definition of a roadmap for HealthGrids.

Database Management Systems↗
PubMed1999

Ways of experiencing asthma management. Variations among general practitioners in Sweden.

OBJECTIVE: To identify and describe variations in ways of experiencing asthma management among general practitioners (GPs) in Sweden. DESIGN: Descriptive and explorative study using a phenomenographic approach. Semi-structured tape-recorded face-to-face interviews, focusing on the GP's own experiences regarding asthma management. SETTING: Primary health care. SUBJECTS: Twenty GPs (12 men, eight women) from 16 health centres in seven counties in central Sweden, 15 from rural areas and small cities and five from medium sized cities or Stockholm suburbs. MAIN OUTCOME MEASURES: Descriptions of ways of experiencing asthma management. RESULTS: Four categories were identified, which described qualitatively different ways of experiencing asthma management: A. The GP focuses on transferring factual knowledge to the patient; B. The GP primarily addresses the patients' application of knowledge in management of the disease; C. The GP aims at improving the patients' understanding of the disease and its management as a prerequisite for self-management; D. The GP concentrates on how to maintain/improve the patient's quality of life despite the asthma disease. CONCLUSION: The GPs describe their ways of experiencing asthma management in qualitatively different ways, likely to have implications for patient care and educational programmes on asthma for GPs.

Asthma↗
PubMed2004

Peak flow monitoring for guided self-management in childhood asthma: a randomized controlled trial.

We asked whether the addition of PEF recordings to a symptom-based self-management plan improved outcome in school children with asthma. In an open-randomized, parallel-group, controlled trial, we studied children aged 7-14 years with moderate asthma. After a 4-week run-in, 90 children were randomized to receive either PEF plus symptom-based management or symptom-based management alone for 12 weeks. Thresholds for action based on PEF were 70% of best (for increasing inhaled steroids) and 50% of best (for commencing prednisolone). Children were asked to perform twice-daily spirometry at home (using an electronic recording spirometer that revealed only PEF to the study group alone) and to record a symptom diary. The mean daily symptom score was the main outcome. There were no differences between groups in mean symptom score or in spirometric lung function, PEF, quality of life score, or reported use of health services over 12 weeks. During acute episodes, children responded to changes in symptoms by increasing their inhaled steroids at a mean value of PEF of greater than 70% of best so that overall PEF did not contribute to this important self-management decision. Knowledge of PEF did not enhance self-management even during acute exacerbations.

Adolescent↗
PubMed1993

Nursing knowledge: acute postoperative pain management in the elderly.

1. The inadequate management of acute postoperative pain among adults is well documented. Studies have shown that 75% or more of hospitalized adult patients following surgery suffer moderate or intense pain even with the use of analgesics. Also, physicians under-prescribe narcotic analgesics and nurses administer less than the patient could receive. 2. Nurses' ineffective approaches to the management of pain have been attributed to inappropriate fears of addiction and respiratory depression, rigid attitudes regarding what constitutes adequate pain relief, and misunderstandings about the physiologic and psychologic components of pain. 3. The results of this study support McCaffery's (1989) finding that nurses do not understand the effective use of narcotics in relation to pain management.

Adult↗
PubMedDate not supplied

[Top medical management and levels of knowledge about the application of the D.lgs. 626/94].

The incorporation into Italian legislation of the European Community directives on the improvement of health and safety at work imposes new duties on the department heads of hospital departments. Their level of knowledge and information on several safety problems--occupational infections, exposure to chemical agents, use of antineoplastic and antiviral drugs, use of protective garments and devices, exposure to ionizing and non ionizing radiations, use of electric devices, lifting and loading, fire prevention--was surveyed in a large teaching hospital in northern Italy, via a check-list derived from Italian and international experience. Both knowledge and information resulted rather low, with particular regard to chemical, electric and fire hazards. The ignorance of department heads about common safety and prevention procedures in hospital work does not allow them to carry out their role according to the new requirements of Italian legislation. However, as they "must" know and have criminal responsibility in case of accidents or diseases due to their unawareness, appropriate courses are needed to fulfil law and safety requirements.

Accident Prevention↗
PubMed2001

Assessment and intervention knowledge of nurses in managing catheter patency in continuous bladder irrigation following TURP.

Continuous bladder irrigation (CBI) is an established procedure designed to prevent the formation and retention of blood clots following transurethral prostatectomy (TURP). The purpose of this study was to evaluate a tool designed to determine what steps the nurse should follow to assess whether a catheter is blocked and the actions to be taken to restore catheter patency for CBI.

Analysis of Variance↗