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Biomedical subjects

B O'Brien

Publications and source records attributed to B O'Brien.

18 recordsLinked to original sources
PubMed1992

Beyond empathy: expanding expressions of caring.

In this paper, a model describing nurses' responses to patients who are suffering is presented. The nurse's level of engagement with the patient is affected by whether the caregiver is focused on him-/herself or on the sufferer (i.e. embodied with the patient) and whether the caregiver is responding reflexively or with a learned response. Four types of communication patterns are identified: engaged responses (first-level) are used in a connected relationship; when the nurse responses reflexively and is focused on him-/herself, the response is reflected; when the caregiver is patient-focused, a learned response is labelled a professional response; and a self-focused, learned response is labelled detached. Examples of each type of response are provided.

Communication↗
PubMed1992

Nausea and vomiting during pregnancy: effects on the quality of women's lives.

More than 70 percent of all pregnant women experience nausea and vomiting during pregnancy, and 28 percent report that symptoms cause them to change their usual activities. We investigated the magnitude of problems that nausea and vomiting impose on the lifestyle of pregnant women and their families. Twenty-seven women who were experiencing different degrees of nausea and vomiting were selected from 147 pregnant women and asked to participate in semistructured telephone interviews. All participants reported changes in family, social, or occupational functioning as a result of these symptoms. Nausea and vomiting can impose substantial lifestyle limitations on pregnant women that can have short- and long-term consequences for them and their families. Both the duration and severity of symptoms were greater for many participants than is generally believed. All participants reported that recumbent rest or dietary alterations provided relief. Caregivers should recognize and validate the need for pregnant women to make changes in lifestyle that will enable them to achieve comfort.

Adult↗
PubMed1992

Exploring empathy: a conceptual fit for nursing practice?

After three decades, the efficacy of empathy in the clinical setting remains undocumented. Recently, concerns have been raised that the concept may be inappropriate and even harmful to the nurse-patient relationship. An analysis of the concept indicates that empathy consists of moral, emotive, cognitive and behavioral components. By tracing the integration of this concept into nursing, we suggest that empathy was uncritically adopted from psychology and is actually a poor fit for the clinical reality of nursing practice. Other communication strategies presently devalued, such as sympathy, pity, consolation, compassion and commiseration, need to be reexamined and may be more appropriate than empathy during certain phases of the illness experience. Directions for future research are suggested.

Behavior↗
PubMed1990

Outcome assessment in cardiovascular cost-benefit studies.

The scarcity of health resources and development of new treatments have introduced a need to assess health care interventions in the areas of both costs and benefits. Information on costs and benefits of one treatment program relative to another can assist decisions about resource allocation by indicating which interventions offer the greatest benefit at the least cost. Economic evaluation is dependent on accurate definition and appropriate measurement of outcome or benefit. This article reviews a number of evaluation techniques and cost-benefit studies associated with cardiovascular medicine. The focus is on health-related quality of life, the methodology, and the problems encountered therein. Methods for combining quantity and quality of life are discussed with reference to a composite measure of health outcome, quality-adjusted life years.

Cardiac Rehabilitation↗
PubMed1990

Jokes and reassurance are not enough: ways in which nurses relate through conversation with elderly clients.

An ethnographic study was conducted into the style of conversation registered nurses used with elderly residents during activities of morning care. Speech was analysed into basic components of speech act categories (e.g. explanation, instruction, reassurance). Patterns of speech style were seen to vary in relation to the physical procedure being carried out, and to function as an adjunct to the smooth execution of this physical activity. However, they were also seen to have an important psychological function reflecting a particular way of relating. Some morning-care activities--the journey--were associated with a more personally engaging social interaction which appeared to be mutually beneficial to nurse and resident. Other approaches to morning care--the dissection--appeared to constrain the way the nurse interacted, producing a more formal style of relating. Findings were discussed in terms of optimal use of physical activities of nursing care to achieve greatest benefit in relation to the psychological needs of the resident, as addressed through verbal interaction.

Aged↗
PubMed1978

Microvascular second toe transfer for digital reconstruction.

Reconstruction of a severely damaged hand, with multiple amputations of digits, presents a difficult reconstructive problem. The development of a safe method of transfer of the great toe for thumb reconstruction, using the dorsalis pedis artery and the saphenous vein, suggested the possibility of one-stage microvascular transfer of the second toe for reconstruction of fingers. In two patients a one-stage transfer of the second toe was done to replace an index finger and in another for restoration of part of the left ring finger. The transplants survived without anticoagulants and vessel complications were not encountered. Sensory return was adequate and a significant improvement in function was achieved.

Accidents, Occupational↗
PubMed1978

Neurovascular free foot flaps in reconstruction of the mutilated hand.

The neurovascular free flap from the first web region of the foot affords unrivalled potential for refurbishing sensibility to the denervated hand. Its greatest application is when no conventional island flap tissue remains for transfer. Its two-point discrimination is only moderate, but when used for thumb reconstruction, its sensibility is adequate because no functional substitute exists. Functionally and cosmetically it is superior to other methods of thumb reconstruction because of its pulp, size, and nail availability. There are no finger identification problems and secondary donor defects are minimal.

Adult↗
PubMedDate not supplied

Surgical opportunism in emergency hand surgery.

Surgical opportunism is the exploitation of circumstances at the time of surgery which will maximize the ultimate functional result. This may be an imaginative original application of surgery and regularly demands a degree of lateral thinking to visualize the opportunity. It involves particularly the careful appraisal of all damaged or amputated tissues and assessment as to their potential usefulness. Microvascular anastomosis greatly broadens the scope of opportunism in emergency hand surgery.

Amputation, Traumatic↗