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Biomedical subjects

D C Webster

Publications and source records attributed to D C Webster.

18 recordsLinked to original sources
PubMed1997

Caring for the caregiver: expanding ways of knowing through experiments in self-care.

Graduate nursing students in a required course on concepts and processes of health and healing had the option to do an experiment in self-care. Included were exercises related to biofeedback, aesthetics, diet/nutrition, dreams, ethnicity, fairytales, values, physical exercise, ultradian rhythms, journaling, and a self-care practice of choice. Feedback on the exercises indicated that, based on group means, the values exercise was the most difficult. Students reported they would be most likely to continue using aesthetics and physical exercise, awareness of ultradian rhythms, and their personally preferred self-care activity. These exercises were also the ones they would be most likely to suggest to clients.

Education, Nursing, Graduate↗
PubMed1995

Self-care strategies used for acute attack of interstitial cystitis.

OBJECTIVE: To determine the kinds of self-care used by women with interstitial cystitis and to find effective ways to manage symptoms of acute attack. STUDY DESIGN: One hundred thirty-eight women with interstitial cystitis completed a survey indicating how often they used and how effective they found strategies in four physical self-care subdomains (medication, treatment, diet, and body comfort) and three psychologic self-care subdomains (cognitive/stress reduction, distraction, and help-seeking). RESULTS: Descriptions of symptoms during an "acute attack" are more consistent with symptoms described "at onset" than symptoms experienced "currently." Physical strategies most used for acute attack included use of narcotics, antidepressants, and bladder analgesics, in addition to limiting the diet to bland or starchy foods, wearing loose clothing, taking hot baths, and using a heating pad over the pubis. Psychologic strategies most used included watching television, prayer, and seeking support from a significant other, family members, friends, and other patients with interstitial cystitis. CONCLUSIONS: Some psychologic and physical strategies found to be effective for other chronic pain conditions, such as biofeedback, alternating use of heat/cold, self-hypnosis, and redefining pain sensations were seldom used. Other nonmedical interventions such as massage and imagery, when used, were found to be more moderately to highly effective. Information about self-care and access to support groups may increase exposure to multiple ways of handling acute attacks.

Acute Disease↗
PubMed1994

Introducing solution-focused approaches to staff in inpatient psychiatric settings.

The authors describe several approaches to introducing solution-focused ideas to inpatient psychiatric nursing staff and psychiatric nursing students. The approach is intended to show the basic values of this approach in the process of helping participants become acquainted with concepts central to newer models of brief psychotherapy. The format uses humor, small group experiential case examples along with didactic approaches to facilitate new ways of thinking congruent with new models of therapy.

Education, Nursing↗
PubMed1994

Use and effectiveness of physical self-care strategies for interstitial cystitis.

Interstitial cystitis is a painful disease that primarily affects women. It involves a chronic bladder inflammation of unknown etiology and unpredictable course. There is no consensus about treatment. Women with interstitial cystitis report using multiple strategies and interventions to prevent and manage urinary urgency, frequency, and suprapubic pain. A survey questionnaire on self-care strategies was completed by 138 members of the Interstitial Cystitis Association. Subjects indicated how often they used more than 300 self-care strategies and the effectiveness of these strategies. This article reports findings from five physical subdomains (medications, treatments, hygiene, diet, and body comfort). Among those who report actually using the methods the effectiveness ratings for many body comfort strategies are comparable to the reported effectiveness of medications (including narcotics) for managing mild to moderate symptoms.

Chronic Disease↗
PubMed1993

Interstitial cystitis: women at risk for psychiatric misdiagnosis.

Interstitial cystitis (IC) is a form of painful bladder disease, characterized by chronic urinary urgency, frequency, and pain without evidence of bacterial infection. Ninety percent of patients with IC are women. Somatization disorder is a psychiatric diagnosis, given most often to women who report a variety of symptoms, such as dysmenorrhea, burning in sex organs, dyspareunia, irregular menstrual periods, and painful urination. Because diagnosis of interstitial cystitis may take many years, health care providers must be alert to the risks of the overdiagnosis of psychiatric problems and the underdiagnosis of interstitial cystitis.

Adult↗
PubMed1990

Solution-focused approaches in psychiatric/mental health nursing.

Multiple social and financial factors dictate that therapies of all kinds be oriented toward producing measurable changes in clients. Crisis intervention is one therapy approach that often produces measurable changes in clients. However, this approach may not be useful for individuals unable to identify a precipitating event, or who want change beyond returning to a previous level of functioning. This article reviews the basic tenets of solution-focused therapy in order to orient nurses to its potential utility for psychiatric/mental health practice.

Goals↗
PubMed1986

Obstetric anaesthetic services in the Yorkshire region.

A survey of obstetric anaesthetic services in the Yorkshire region, where about 44,500 deliveries take place annually, showed that inadequacies exist in the service to patients. A 24 hour epidural service is available in only nine of 19 consultant units, and in about seven units patients may have to wait up to half an hour for an anaesthetist to be available for an obstetric emergency. Additional consultant anaesthetic sessions are urgently required as well as centralisation of some units.

Anesthesia, Epidural↗
PubMedDate not supplied

Self-care effectiveness and health outcomes in women with interstitial cystitis: implications for mental health clinicians.

Several researchers have discussed the need to define "outcomes" in health care more holistically, particularly from women's health, chronic illness, and self-care perspectives. Interstitial cystitis (IC), a chronic illness that primarily affects women, is a poorly understood condition that can produce hopelessness and suicidal ideation. Management of IC usually requires behavioral changes in all life dimensions. Multidimensional health outcomes were examined in a survey of 138 women with IC. Item-item and item-factor correlations were used to identify relationships between indicators of health outcomes and self-reported effectiveness of more than 300 self-care strategies used to manage IC. The effectiveness of behavioral and cognitive self-care strategies correlated differentially with dimensions of health. Uncertainty correlated most strongly with the quality of relationships with health care providers. Psychiatric nurses are well prepared to address the complex body-mind phenomena of IC, promoting effective self-care strategies while maintaining a supportive therapeutic relationship.

Adaptation, Psychological↗
PubMedDate not supplied

Use and effectiveness of psychological self-care strategies for interstitial cystitis.

We explore two questions. First, What psychological self-care strategies do women use to manage interstitial cystitis (IC), and how effective are they? Second, How do self-reported cognitive-behavioral and stress reduction activities compare with the coping options hypothesized by Draucker (1991) to be available to women diagnosed with IC? One hundred thirty-eight women with IC rated the use and effectiveness of 53 psychological self-care strategies as well as levels of uncertainty related to the illness. Findings indicated that the women used a wide variety of psychological self-care strategies, including information seeking, self-validation, rejection of pathologizing psychological explanations, and downward comparison to provide perspective. Even after diagnosis, most of the women experienced considerable uncertainty regarding changing symptoms and ability to predict and plan. Use and effectiveness of most psychological strategies appeared to be more strongly related to being involved in a support group, than to current status of the illness.

Adult↗
PubMedDate not supplied

Recontextualizing sexuality in chronic illness: women and interstitial cystitis.

Interstitial cystitis (IC) is a chronic bladder condition that affects ten times more women than men. The major symptoms of IC include urinary frequency, urgency, and suprapubic pain. Dyspareunia is another common complaint. The construct of sexuality can best be understood in context, from the perspective of the study participants. To better understand the changes in sexuality experienced by women with IC, the findings from a survey of 138 women with IC are compared with responses from an earlier pilot interview with ten women with IC. Managing any chronic illness requires changes in many aspects of one's life, including activities, self-perceptions, relationships, and roles. Women with IC described what was important to them "as women" in the context of their current primary life values of health, love, and family. Changes in the sexual relationship were described in the context of the effects of having IC and the centrality of maintaining relationships. The healing potential of participation in support groups is discussed in relation to the women's desire to maintain independence and to help others with the disease.

Adaptation, Psychological↗
PubMedDate not supplied

Caring and nursing's metaparadigm: can they survive the era of managed care?

Considering the growing power of third-party payers to control the length and methods of treatment, the authors summarize alternative treatment models of providing care. These models are evaluated within the context of nursing's metaparadigm. Clinical examples are provided to illustrate how focusing on client strengths and alternative solutions differs from more traditional approaches to treatment.

Empathy↗
PubMedDate not supplied

Modeling the client's world through brief solution-focused therapy.

The shift to a managed care philosophy means that clients with psychiatric needs are likely to have both fewer and briefer inpatient hospitalizations. Identification of focused goals and measurable outcomes may not translate easily into inpatient programs that have been more process oriented or have based definitions of improvement on complete or near-complete remission of the admission diagnosis. In the context of these shifts, nursing's focus on maintaining a safe environment, developing a therapeutic relationship, providing information, and valuing holistic and individualized care may be lost in programs that treat all clients in the same "packaged" programs. This article describes the philosophical assumptions that underlie the brief inpatient program. The next article in this issue describes how solution-focused therapeutic modalities are used in the continuum of care.

Humans↗
PubMedDate not supplied

Brief inpatient psychiatric treatment: finding solutions.

The shift to a managed care philosophy means that clients with psychiatric needs are likely to have both fewer and briefer inpatient hospitalizations. Identification of focused goals and measurable outcomes may not translate easily into inpatient programs that have been more process oriented or have based definitions of improvement on complete or near-complete remission of the admission diagnosis. In the context of these shifts, nursing's focus on maintaining a safe environment, developing a therapeutic relationship, providing information, and valuing holistic and individualized care may be lost in programs that treat all clients in the same "packaged" programs. The previous article in this issue described the philosophical assumptions that underlie our brief inpatient program. This article describes how solution-focused therapeutic modalities are used in our continuum of care.

Adult↗