Alcohol-induced Cushingoid syndrome.
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Adult↗
Biomedical subjects
C M Ruland
Publications and source records attributed to C M Ruland.
Alcohol-induced Cushingoid syndrome.
Explore the source record for details and available documents.
Adult↗
Theory construction based on standards of care: a proposed theory of the peaceful end of life.
The contribution of developing a theory from this standard of care is that it can express a new unifying idea about the phenomenon of peaceful end of life for terminally ill patients. It allows for generating and testing hypotheses that can provide new insights into the nature of this phenomenon and can contribute to increased knowledge about nursing interventions that help patients toward a peaceful end of life. The process of theory development from standards of care as described in this article also can be applied to other phenomena. Clinical practice abounds with opportunities for theory development, yet nurses often do not use theories to guide their practice. Until now, little guidance has been provided to tap the richness of clinical knowledge for the development of middle-range theories. Whereas the method described in this article may still be further refined, it offers a promising approach for the development of theories that are applicable to practice and move beyond the scope of grand theories. Thus deriving theories from standards of care can offer an important contribution to the development of the discipline's scientific knowledge base and enhanced practice.
Evidence-Based Medicine↗
Women's patterns of exercise following cardiac rehabilitation.
BACKGROUND: Studies of long-term exercise maintenance after an acute cardiac event have been conducted almost exclusively with men, and the findings cannot be generalized to women. OBJECTIVES: The aim of this study was to identify women's exercise patterns and adherence to recommended exercise maintenance after a cardiac rehabilitation (CR) program. METHOD: Forty women who had a myocardial infarction or had undergone coronary artery bypass graft (CABG) surgery were recruited through convenience sampling immediately after completion of a phase II CR program. Exercise frequency, duration, and intensity were measured using wristwatch heart rate (HR) monitors during exercise for 3 months. RESULTS: Results indicated that 12 of 40 (30%) women exercised five times or fewer during the 3-month study period. Only 11 women (27.5%) exercised three or more times per week. Women exercised an average of 5.2 sessions within their target HR during the entire study period. Maintenance of exercise dropped consistently during the course of the study. Although 83% of the participating women started exercising during the first month, after 1 month one third of the participants had stopped exercising. During the last week of the study, only 50% of the women were still exercising. CONCLUSIONS: These findings indicate the women are exercising well below the recommended guidelines for exercise after acute cardiac events.
Adult↗
Decision support for patient preference-based care planning: effects on nursing care and patient outcomes.
OBJECTIVE: While preference elicitation techniques have been effective in helping patients make decisions consistent with their preferences, little is known about whether information about patient preferences affects clinicians in clinical decision making and improves patient outcomes. The purpose of this study was to evaluate a decision support system for eliciting elderly patients' preferences for self-care capability and providing this information to nurses in clinical practice-specifically, its effect on nurses' care priorities and the patient outcomes of preference achievement and patient satisfaction. DESIGN: Three-group quasi-experimental design with one experimental and two control groups (N = 151). In the experimental group computer-processed information about individual patient's preferences was placed in patients' charts to be used for care planning. RESULTS: Information about patient preferences changed nurses' care priorities to be more consistent with patient preferences and improved patients' preference achievement and physical functioning. Further, higher consistency between patient preferences and nurses' care priorities was associated with higher preference achievement, and higher preference achievement with greater patient satisfaction. CONCLUSION: This study demonstrated that decision support for eliciting patient preferences and including them in nursing care planning is an effective and feasible strategy for improving nursing care and patient outcomes.
Activities of Daily Living↗
Developing a decision support system to meet nurse managers' information needs for effective resource management.
This article describes the development of a decision support system called CLASSICA, which assists nurse managers in financial management, resource allocation, activity planning, and quality control. CLASSICA integrates information about patient flow and activity, staffing, and the cost of nursing care at the nursing-unit level. The system provides assistance in planning activities, balancing the budget, and identifying barriers to unsatisfactory resource management. In addition, CLASSICA contains forecasting and simulation options to analyze the influence of factors that affect nursing costs. This article describes the system's development process steps to tailor it to the needs of nurse managers and their existing work practices. Nurse managers actively participated in defining their tasks and responsibilities; identified barriers and difficulties in managing these tasks; defined information needs, data input, and output and interface requirements; and identified expected benefits. Clear communication of project goals, strong user involvement, and purposeful benefit planning was used to achieve the goals for CLASSICA: (1) to provide essential information and decision support for effective financial management, resource allocation, activity planning, and staffing; (2) to improve nurse managers' competence in financial management and decision making; (3) to improve cost containment; and (4) to provide a helpful and easy to use tool for decision support.
Decision Support Systems, Management↗