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Biomedical subjects

A G Gift

Publications and source records attributed to A G Gift.

At least 37 records · Page 2Linked to original sources

Dyspnea and fatigue.

Research regarding dyspnea and fatigue has focused on the factors contributing to the symptoms. Physiologic factors, such as muscle use; psychological factors, such as anxiety and depression; and situational factors, such as hot weather, contribute to the symptoms of dyspnea and fatigue. Increased symptoms lead to impaired functional ability. Strategies for relief of dyspnea and fatigue can be obtained from patient report, but further research is needed to test the effectiveness of nursing interventions.

Adult↗

Utilizing research assistants and maintaining research integrity.

The appropriate use and supervision of research assistants is essential to the success of a research study and the avoidance of academic misconduct. The focus of this article is to provide guidelines for the new principal investigator regarding hiring, contracting, orienting, monitoring, and evaluating research assistants. Particular attention is given to techniques that will avoid academic misconduct resulting from research assistants being uninformed or unsupervised.

Biomedical Research↗

Sensations during chest tube removal.

Nurses prepare patients for chest tube removal, yet little has been written to indicate the sensations to be expected during this routine procedure. The sensations reported by patients and factors that could influence those sensations were examined in this study. The sample consisted of 36 patients after thoracic surgery (24 men and 12 women), all of whom were scheduled to have either a mediastinal or a pleural tube removed. They reported their sensations and the intensity of those sensations (using a 100 mm visual analog scale) within 15 minutes after tube removal. The most frequently reported sensation during chest tube removal was burning, followed by pain and pulling with mean intensities of 64, 62, and 45, respectively. Subjects reported having few sensations after the tube was removed with only five reporting soreness in the chest. The sensations and intensities did not differ for those who did and did not receive analgesia or for those having a pleural tube versus a mediastinal tube removed. The sensations were similar for the old and young subjects with younger subjects reporting higher intensities. Women reported pain more frequently than men, but the intensities of the sensations reported by men and women were not significantly different. The sensations reported during chest tube removal differ from those described in the literature and can be used to prepare patients more appropriately for chest tube removal.

Analgesia↗

Utilization pattern of clinical nurse specialists in the Baltimore-Washington area.

In the present cost containment environment, hospitals often change their employment patterns. Nurses in advanced practice roles are particularly vulnerable to reassignment. In order to determine if the employment of Clinical Nurse Specialists (CNSs) in the Baltimore-Washington area had decreased and to determine what specialty areas employed the most CNSs, a survey of all area hospitals was conducted. The nursing departments of all 88 hospitals were contacted by phone with 40 of them (45%) agreeing to provide data. Seventeen institutions reported employing a total of 119 CNSs. Of these, only 12 required a Master's degree for nurses to hold that position. As expected, larger institutions employed more CNSs. This role appears to be stable, with only two institutions having eliminated CNS positions recently and five reporting plans to add such positions in the near future. Most CNSs reported either directly or indirectly to the Director of Nursing. Those in positions funded by another source reported to personnel in the funding department or agency. Almost all CNSs had clinical titles, and Psychiatric, Oncology, Medical and/or Surgical, Pediatrics or Critical Care were the most prevalent specialties mentioned. The CNS role is a viable role in the Baltimore-Washington area even in this time of cost containment. Most CNSs are identified with their area of clinical specialization.

Baltimore↗

Dyspnea.

A multidimensional model of dyspnea that includes sensation, perception, distress, response, and reporting components is presented. Assessment tools currently available are evaluated as are recent research findings for pharmacologic, oxygen, physical, and psychologic treatments. This article concludes by suggesting a role for the nurse in dyspnea amelioration.

Dyspnea↗

Psychophysiologic aspects of dyspnea in chronic obstructive pulmonary disease: a pilot study.

The level of dyspnea reported by the patient with chronic obstructive pulmonary disease is related to both the physiologic and psychologic state of the person at the time. The purpose of this pilot study was to explore, from a psychophysiologic perspective, the differences in anxiety, depression, and somatization during times of high and low levels of dyspnea. Six male subjects with chronic obstructive pulmonary disease, with a mean age of 64 years and a mean forced expiratory volume in 1 second that was 44% of predicted, completed the study. They were assessed for clinical signs and their level of dyspnea indicated on a vertical visual analogue scale, after which they completed the Spielberger State Anxiety Inventory and the Brief Symptom Inventory. Arterial blood was then drawn for blood gas analysis and determination of cortisol level. All measures were repeated twice, once when the subject reported a high level of dyspnea and once when he reported a low level. Analysis of the data by use of t tests for paired groups indicated that during times of high dyspnea levels subjects had greater anxiety, accessory muscle use, cortisol level, and PCO2 level. Subjects receiving oral prednisone had high depression levels that increased during times of severe dyspnea. Somatization, PO2, respiratory rate, depth of respiration, and other clinical signs did not change with dyspnea level. These results indicate that dyspnea is accompanied by both psychologic and physiologic changes that can be targeted to assist in alleviating this distressing symptom.

Aged↗

Depression, somatization and steroid use in chronic obstructive pulmonary disease.

Steroid therapy has become part of the adjunctive treatment for COPD patients in some settings. Emotional changes have been reported in some patients while on these medications, but whether these changes are associated with the pathophysiological state or a side effect of the medication is not known. In this study self-reports of depression and somatic complaints were compared between two groups of COPD patients, 20 not receiving steroids and 20 receiving steroids. Both groups demonstrated comparable levels of disease and somatic complaints. Mean FEV1 value for those not receiving steroids was 34% of predicted while the mean for those receiving steroids was 30% of predicted. Depression was found to be significantly higher (t = 11.21, df = 38, p less than 0.01) in the group receiving steroids when compared to those not receiving steroids using a Student's t test. The higher degree of depression among steroid treated COPD patients has implications for clinical practice. The emotional status of this group of patients needs to be monitored and interventions initiated when necessary.

Aged↗

Clinical research with patients in crisis: pitfalls and solutions.

Clinical research involving patients in crisis may be difficult to conduct because of the psychophysiological changes in the patient and the hectic environment of the health care setting. Clinical nurse specialists have the opportunity to expand nursing knowledge and contribute to nursing practice through initiation and/or participation in research with people in crisis. This article identifies potential pitfalls in conducting research with patients in crisis and suggests strategies for selecting a research design, data collection methodologies, and obtaining consent or approval.

Clinical Nursing Research↗

Assessment of physiologic instruments.

Nursing researchers are advised to consider the reliability and validity of psychologic instruments used in research; however, evaluation of physiologic, or clinical, instruments is not always given the same attention. Reliability and validity issues related to physiologic measures will be discussed. Terms commonly used for the evaluation of physiologic instruments, such as "accuracy," "precision," and "sensitivity," will be explained, with parallels drawn to traditional measurement terms. Sources of potential measurement error, such as environment, user, subject, machine, and interpretation error, will be explained and specific examples given from cardiopulmonary nursing research.

Diagnostic Errors↗