Search PubMed⌕ Search

Biomedical subjects

B A Ferrell

Publications and source records attributed to B A Ferrell.

32 records · Page 2Linked to original sources
PubMed1993

A randomized trial of low-air-loss beds for treatment of pressure ulcers.

OBJECTIVE: To assess the effectiveness of low-air-loss beds for the treatment of pressure ulcers in nursing homes. DESIGN: Prospective, randomized, clinical trial. SETTING: Three teaching nursing homes in Los Angeles, Calif. SUBJECTS: Eighty-four nursing home residents with trunk or trochanter pressure ulcers (Shea stage > or = 2). INTERVENTIONS: Subjects were randomly assigned to use either a low-air-loss bed (n = 43) or a 10-cm corrugated foam mattress (n = 41) throughout the healing of their ulcers. OUTCOME MEASURES: Ulcers were assessed twice weekly using surface area and two observational scales (median follow-up, 37.5 days; range, 4 to 571 days). RESULTS: Groups were similar with respect to demographics, medical variables, wound care, and early dropouts. Results indicate more than a threefold improvement in median rate of healing for low-air-loss beds compared with foam mattresses (9.0 vs 2.5 mm2/d; P = .0002). This finding was true for deep as well as superficial ulcers (deep ulcers, 9.9 vs 0.7 mm2/d; P = .02; superficial ulcers, 9.0 vs 3.2 mm2/d; P = .004). Cox regression models revealed that the bed, ulcer depth, and fecal continence had independent effects on healing. After controlling for fecal continence, the deep and superficial subgroups using low-air-loss beds remained 2.5 times more likely to heal in a given length of time compared with those using foam mattresses (combined cure probability ratio, 2.66; 95% confidence interval, 1.34 to 5.17; P < .004). CONCLUSION: Low-air-loss beds provide substantial improvement compared with foam mattresses despite other factors in pressure ulcer healing.

Aged↗
PubMed1992

Care of cancer patients in nursing homes.

Nursing homes provide supportive environments for many cancer patients with stable functional and medical problems. The majority of cancer patients in nursing homes require basic palliative care. Patients with acute medical complications requiring intensive monitoring, technical treatments, or intensive rehabilitation are better suited for hospital settings or other skilled facilities where appropriate resources are readily available. Much of what we have learned over the last 15 years about the palliative care of cancer patients can be directly applied to the care of elderly cancer patients in nursing homes. With critical planning and realistic goals, nursing home care can provide dignity and improved quality of life for these patients.

Aged↗
PubMed1991

Principles of pain management in older people.

The management of chronic pain should be a priority in geriatric care. Pain is a common problem that has tremendous potential to influence the physical function and quality of life of elderly people during their remaining years. Much research and education is still needed to further our understanding of pain and its management among elderly people. Existing pain management strategies should be tailored for the special needs of the geriatric population. Applications of "high tech" pain management strategies, such as morphine pumps and chronic spinal infusions, need to be clarified for older people. Finally, family and caregiver considerations should be included in chronic pain management strategies.

Aged↗
PubMed1991

Family factors influencing cancer pain management.

The purpose of this study was to describe family factors which influence cancer pain. Previous research has focused on the patients' and professional caregivers' perspective of pain. Cancer pain is an intense burden on the entire family as well as on the patient. Findings of the study demonstrate family perceptions of pain, caregiver burden associated with pain, caregiver moods and differences in caregiver experiences of pain between three sites of care including a hospice, a community hospital and a cancer centre. Understanding the perspective of the family caregivers and their role in pain management can assist health care providers in management of the patient's pain.

Adult↗
PubMed1991

Geriatric home health care. Conceptual and demographic considerations.

This article has explored conceptual and demographic aspects of HHC and the distinction between formal and informal care. HHC for elderly persons is shown to be mainly an informal, familial activity with important formal professional, skilled, and unskilled components. Formal home health care in the United States has undergone a historic transformation with the rise of third-party payment as a principal, defining force and with demographic and epidemiologic transition of the general population. Recent national studies demonstrate that the principal population group receiving HHC services--the chronically ill, functionally limited, noninstitutionalized elderly--is growing in number and as a proportion of the group with home and community service needs. Although diverse formal service innovations are being explored to meet these growing needs, current involvement of medical professionals in formal HHC emphasizes relatively short-term, post-acute therapeutic and restorative care offered through Medicare-certified home health agencies.

Activities of Daily Living↗
PubMed1991

Pain management at home.

The management of chronic pain should be a priority in geriatric home care. Pain is a common problem that has tremendous potential to influence the physical function and quality of life of elderly people during their remaining years. The experience of pain and its management at home are not analogous to institutional settings. Family and caregivers have important influences on pain management and may require education and support for the long-term management of chronic pain patients. Existing pain management strategies should be tailored to meet the special needs of geriatric patients and be sensitive to caregiver concerns. Implications, indications, and applications for high-tech pain management strategies need to be clarified for the management of older people at home.

Acute Disease↗
PubMed1990

Pain in the nursing home.

Pain is an understudied problem in geriatric medicine and especially among nursing home residents. The focus of this study was to describe the scope of the problem of pain in a long-term care facility. Ninety-seven subjects from a 311-bed multilevel teaching nursing home were interviewed, and charts were reviewed for pain problems and management strategies. Functional status, depression, and cognitive impairment were also evaluated. Results indicate that 71% of residents had at least one pain complaint (range, 1-4). Of subjects with pain, 34% described constant (continuous) pain and 66% described intermittent pain. Of 43 subjects with intermittent pain, 51% described pain on a daily basis. Major sources of pain included low back pain (40%), arthritis of appendicular joints (24%), previous fracture sites (14%), and neuropathies (11%). Moderately strong correlations were found between pain and infrequent attendance at recreational and social activities (r = .50). However, little correlation was observed between pain and the Yesavage Depression Scale, the Folstein Mini-Mental State Scale, or basic ADLs measured by the Katz Scale. Pain-management strategies consisted of analgesic drugs, physical therapy, and heating pads. Only 15% of patients with pain had received medication within the previous 24 hours. The findings suggest that pain is a major problem in long-term care. Strategies for pain management appear to be limited in scope and application in this setting. Important barriers were identified that influence the reporting and management of pain in this setting.

Aged↗
PubMed1978

Ventricular morphology and pumping ability of exercised spontaneously hypertensive rats.

Spontaneously hypertensive rats (SHR) and two strains of normotensive Wistar rats were subjected to a 5 day/wk swimming program to determine whether the heart of the SHR could respond to an additional stimulus to cardiac growth. Swimming was tolerated well by all rats. Although body weight of the exercised groups was not significantly reduced, both the right and left ventricular weights of all exercised groups were increased. Left ventricular circumference and chamber volume were increased without a change in free wall thickness in all exercised groups. Ventricular performance was assessed by peak cardiac output and stroke volume attained during rapid intravenous volume loading, both before and after autonomic inhibition. After combined cholinergic and beta-adrenergic inhibition, all exercised rats had slower heart rates and higher peak stroke volume than respectively sedentary controls. Thus, exercised SHR had the same alterations in cardiac mass and performance as exercised normotensive rats. Despite the initial presence of left ventricular hypertrophy, the SHR responded appropriately to an additional stimulus for adaptive cardiac growth.

Animals↗
PubMedDate not supplied

A randomized trial of walking versus physical methods for chronic pain management.

We conducted a pilot study to evaluate a practical exercise program for elderly people with chronic musculo-skeletal pain. Thirty-three subjects (mean age, 73 years; 69% back pain; 24% knee pain; 9% hip pain) were randomly assigned to one of three groups. Group 1 received 6-week supervised program of walking. Group 2 received a pain education program that included instruction and demonstration of use of heat, cold, massage, relaxation and distraction. Group 3 received usual care. Outcomes including pain, self-reported health and functional status, and performance-based measures of functional status were evaluated at baseline, at two weeks and at eight weeks (end of study). Attendance was 100% for the education sessions and 93% for walking sessions. No injuries were sustained. Both intervention groups demonstrated significant improvements in pain (p < 0.05) and performance-based measures of functional status (p < 0.05), while the control group had no changes. These data suggest that patient education and fitness walking can improve overall pain management and related functional limitations among elderly people with chronic musculo-skeletal pain.

Aged↗
PubMedDate not supplied

Easing the pain.

Explore the source record for details and available documents.

Aged↗
PubMedDate not supplied

A structured nondrug intervention program for cancer pain.

The management of cancer pain has been a primary focus in the authors' program of oncology nursing research. A study currently in progress entitled, "Assessment and Management of Pain for Elderly Cancer Patients at Home," applies knowledge of the authors' earlier work in an educational nursing intervention for patients with cancer and their family care-givers in the home. The program consists of three parts: (1) an overview of pain, (2) pharmacologic management of pain, and (3) nondrug interventions for pain. The nondrug component of this program is particularly unique in providing structured implementation of nonpharmacologic techniques, which are often neglected in pain management. Five categories of nondrug intervention are used including heat, cold, massage/vibration, distraction, and relaxation. The purpose of this article is to report on the development and initial results of the nondrug portion of a pain education program.

Analgesia↗