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Biomedical subjects

B J Lowery

Publications and source records attributed to B J Lowery.

At least 19 recordsLinked to original sources
PubMed1992

A comparison of patient/nurse perceptions about current and future recovery status.

Research comparing patient and caregiver perceptions suggests that caregivers tend to be negatively biased in their assessment of patients. That is, they are more likely to judge the patients' status more negatively than the patients themselves. The data analyses, however, have not always been as informative about the extent of disagreement. Our data on the extent to which patients who had a myocardial infarction and their nurses' assessments differed suggest that, in the case of the patients' current status, there were no differences in the aggregate between patients' and nurses' assessments. Examination of the discrepancies between the pairs, however, suggests that in some cases nurses are more negative in their assessments than their patients. In the case of beliefs about the future, nurses were significantly more negative, in the aggregate, than patients, and the extent of this difference is further elaborated in the examination of the discrepancies. Nevertheless, with respect to both current and future status, the correlations between patients and nurses were low, indicating little, if any, shared variation. Because this study did not examine the relationship between either patients' or nurses' perceptions of recovery status, and the patients' actual recovery status, further research is needed to further determine the implications of this work. The meaning of these results for clinical nurse specialists (CNS) is discussed.

Attitude to Health↗
PubMed1992

Psychiatric nursing in the 1990s & beyond.

In the decade of the '90s, psychiatric mental health nursing will need to take stock of itself--its practice, its education, and its research--if it is to successfully prepare for the changes in care of the mentally ill. Like psychiatrists, we will need to rethink our agendas in light of new science and technology and rationalize the mental health delivery system and our role in it through systematic research and advocate for a system that provides quality care for the chronically ill and the poor. In the next century, we will need to rethink the basics of nursing care and the leadership roles of nurses as hospitals and the doctor's role within them changes. Psychiatric mental health nurses will need to be at the forefront in advocating for a delivery system that listens to patients and families, that humanizes the dehumanizing experience of hospitalization. The challenges before us are formidable.

Costs and Cost Analysis↗
PubMed1992

Seclusion. The nursing challenge.

The research to date shows that there is not much data to guide nursing decisions about the use of seclusion. The justification for its use is not always as clear as one might hope. Although many patients are secluded for violence against themselves or others, there are others who have not been violent who are secluded. There may be justification for secluding violent patients, but, as indicated earlier, it may reinforce the behavior it is designed to stop. There probably is no justification for secluding patients who make loud noises, refuse to take medication, or refuse to participate in activities. In addition, it is disconcerting that a large percentage of patients are secluded for "escalating agitation," that is, they have not acted violently against themselves or others. What is problematic is that staff are undoubtedly predicting violent behaviors in these patients--predictions that might be erroneous. Thus, there is ample room for injustice to occur. The potential for injustice is even greater if certain patients are singled out for seclusion or if patients are secluded longer than they or the staff think that they need to be, as is indicated in some of the studies to date. Moreover, if unit variables are associated with seclusion activity, this too, may be indicative of decision making at certain times of the day or by certain staff members that may not be in the best interest of the patient. What seems fairly clear is that secluding a patient is a distressing event for staff and is viewed extremely negatively by some patients and as a reward by others.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1992

Why me? Causal thinking, affect, and expectations in myocardial infarction patients.

This study investigated whether patients who seek an explanation for their heart attack, as compared to those who do not, differ in their affect, in expectations about their future recovery, and in expectations about coping with their future. Forty-two myocardial infarction patients were interviewed, in both the acute and convalescent stages, as to whether they had thought about "Why me?" Approximately half of the patients at each stage reported searching for an answer to that question. The patients remained generally consistent in their self-reported anxiety, depression, and hostility over time; however, patients who had not thought about "Why me?" reported less anxiety than those who had. No significant differences were found in affect in patients who gave a specific cause for their heart attack and in those who could not. Patients were significantly less optimistic about their future recovery at follow-up than when they were in the hospital, but there were no differences in expectations for future recovery or for future coping of those who had and those who had not thought about "Why me?"

Adaptation, Psychological↗
PubMedDate not supplied

Advancing care in serious illness: evolution of a center.

Faculty at the School of Nursing of the University of Pennsylvania successfully responded to the National Center For Nursing Research Center grant initiative with a center focused on advancing care in serious illness. The faculty and campus resources available to the proposed center and the initial center research and training program are described.

Academies and Institutes↗
PubMedDate not supplied

Resources to maintain the academic culture.

In summary, the recent attention to the research aspect of our professorial lives brings with it some challenges. The first, of course, is to keep our research agendas alive--to find the resources to nuture new investigators and to provide the support to sustain those who are funded. The second challenge is to rethink our ideas about teaching so that both sides of the coin are addressed: the need to have classroom teachers who are doing research and the need to keep investigators in the classroom.

Faculty, Nursing↗
PubMedDate not supplied

Further analysis of the psychometric properties of the Levine Denial of Illness Scale.

This study contributes cross-validational data with regard to the Levine Denial of Illness Scale from a sample of 152 hospitalized myocardial infarction patients. A factor analysis and subsequent examination of the data yielded four usable factors of denial termed: Cognitive Denial of Illness, Denial of Impact on Future, Denial of Need for Care, and Affective Denial. In an analysis of subscale correlations, these four factor-based scales were related, but distinguishable, thus supporting the idea of the multidimensionality of denial. Furthermore, these factors were not related to demographic variables. Correlating these four scales with standardized measures of affect indicated that it can be useful in research to distinguish between several types of denial of illness in myocardial infarction patients.

Aged↗
PubMedDate not supplied

Disease-related learning and disease control in diabetics as a function of locus of control.

This study investigated the relationship between the individual difference variable, locus of control, and a patient's response to diabetes. Since internal persons have been found to be active information seekers as compared to external persons, it was predicted that internal diabetics would know more about their disease and would, therefore, demonstrate more control over it. As predicted, internal diabetics did have more diabetic information, although this superiority over externals diminished as the length of the disease increased. Contrary to prediction, internal diabetics seemed to incur more problems with disease than externals as the disease progressed. This finding was interpreted as presenting a limiting case to the usual thinking about the superiority of an internal's response to problem situations.

Adult↗
PubMedDate not supplied

Attention versus avoidance: attributional search and denial after myocardial infarction.

OBJECTIVE: In this study the focus was on two strategies: denial (an avoidant strategy) and causal thinking (an attention strategy) and their relationships to affect after myocardial infarction. DESIGN: Descriptive, correlational. SETTING: Large rural medical center. SAMPLE: The sample comprised 152 recently hospitalized patients with first-time myocardial infarction. MEASURES: A denial scale, a question about causal thinking, and an affect adjective checklist measuring anxiety, hostility, and depression. RESULTS: Denial had a weak but significant negative correlation with anxiety (r = -0.18, p < 0.05). However, denial was not significantly related to either depression or hostility. Regression analysis indicated that both denial (F = 4.84, p = 0.02) and the interaction of denial with causal search (f = 4.77, p = 0.009) were predictors of affect. The interaction indicated that those with high denial who had not searched for a cause were least anxious. A large number of subjects used both attention and avoidant strategies. CONCLUSIONS: The main effect for denial suggests that avoidance is a more effective strategy for reducing anxiety after myocardial infarction than causal search, an attention strategy. However, the fact that many subjects used both strategies suggests that they are not mutually exclusive in the process of adaptation after a heart attack.

Affect↗
PubMedDate not supplied

Psychiatric rehospitalization of the severely mentally ill: patient and staff perspectives.

Research findings about psychiatric rehospitalization of severely mentally ill persons have provided few insights into its meaning for patients and staff. An attributional analysis of the causes schizophrenic patients and their staff gave for rehospitalization was used to test the limits of attributions theory in predicting how the event would be viewed. Results indicated that patients tended to give internal attributions for their readmission and believed that the cause was not under their control. Staff also attributed the problem to something internal to the patient, however, they were likely to see the cause as patient effort, which is under patient control.

Adolescent↗
PubMedDate not supplied

Linkages between community mental health centers and public mental hospitals.

Directors of community mental health centers and superintendents of public mental health hospitals in one state were surveyed to gather data on interagency linkages. Implementation of affiliation agreements, exchange of staff training, and exchange of patient information were investigated. Affiliation agreements tended to be implemented with little difficulty and there was more interagency cooperation than that reported in earlier research. However, exchange of training and staff were still areas of minimal interaction. Geographic proximity was found to have a positive influence and competition a negative influence on cooperation. Further attempts at interagency linkages in the interest of continuity of patient care are recommended.

Community Mental Health Centers↗
PubMedDate not supplied

Three sides of the same coin: the analysis of paired data from dyads.

Three types of research questions are commonly asked about data from dyads: (1) What are the overall group differences between the two sets of measurements? (2) What is the association between paired data? and (3) What is the agreement between pairs? These three types of questions about the same dyad dataset lead to different analyses, and the answer to one question does not necessarily help in answering the other questions. The purpose of this article is to highlight the differences among these questions and their respective methods of data analysis. The intent is to stress the necessity for congruence between research questions and the analysis, rather than to present a review of all possible methods of analysis of paired data.

Bias↗