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Biomedical subjects

D J Pesut

Publications and source records attributed to D J Pesut.

29 records · Page 2Linked to original sources
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Deep change.

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Humans↗
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Psychological evaluations, referrals, and follow-up of adolescents after their exposure to Hurricane Hugo.

PROBLEM: There is little understanding of adolescent appraisal of stress and crisis intervention for adolescents who are exposed to major stress such as that of a natural disaster. METHODS: A description of the psychological evaluations, referrals, and follow-up assessments made by nurse practitioners (NPs) and a nurse psychotherapist (NPT) of adolescents (N = 507) in two South Carolina high schools who experienced Hurricane Hugo. FINDINGS: The NPs' evaluations concluded that 63 adolescents (12%) exhibited symptoms of psychological distress. The NPs referred 36 of these adolescents to high school counselors for minor distress or school-related problems and 27 for more intensive clinical evaluation by an NPT. Of the 27 adolescents who were referred to the NPT, 10 had symptoms associated with adolescent adjustment reaction, 8 showed symptoms of depression, 5 revealed symptoms of posttraumatic stress disorder, and 4 complained of serious family problems. CONCLUSIONS: Based on these data and the mental processes described by these adolescents, the authors propose a model and suggest adolescent appraisal of stress and crisis is a critical issue to consider when intervening with adolescents who are exposed to major stressors, including those associated with a disaster.

Adolescent↗
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Metacognitive skills in diagnostic reasoning: making the implicit explicit.

The metacognitive skills of monitoring, analyzing, predicting, planning, evaluating, regulating, and revising frame the nursing process and support clinical reasoning. Nurse educators who encourage metacognitive skill acquisition are likely to accelerate student comprehension, understanding, and mastery of nursing diagnosis, nursing process, and clinical reasoning. The models presented in this article have implications for teaching and learning clinical/diagnostic reasoning.

Cognition↗
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Using metacognitive skills: the quality audit tool.

The authors describe a strategy used to teach clinical reasoning skills to novice diagnosticians. The strategy proposed is the Quality Audit Tool, an instrument designed to help novices use metacognitive skills to critique diagnostic statements and care plans. The Quality Audit Tool has eight frames (Diagnostic Statement, Diagnostic Cues, Functional Relationship, Outcome, Etiology, Nursing Orders, Evaluation, and Clinical Judgment); each frame has a content and process focus. Conducting a Quality Audit enables the novice diagnostician to understand relationships among the parts of a nursing diagnosis, recognize the metacognitive skills used in clinical reasoning, and evaluate knowledge and clinical reasoning against a set of standards.

Clinical Competence↗
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Self-management of recovery: implications for nursing practice.

This article describes and discusses differences in responses to a 60-item survey instrument, the Carolina Self-Regulation Inventory (CSRI) from a selected sample of university faculty and staff. The CSRI was designed to measure the types of self-regulation strategies (SRS) individuals use to facilitate their recovery from illness episodes. When the CSRI was developed, 1,306 university employees participated in the survey. Four hundred eighty (36%) employees classified themselves as faculty; 346 (26%), staff; 418 (32%), midlevel administrators; and 62 (6%), blue-collar workers. This report focuses on the differences between the faculty and staff groups in the survey. Analysis revealed that the staff used a variety of strategies and had higher statistically significant means on the following CSRI subscales: visualization (t = 2.53, P less than .01), self-talk (t = 6.801, P less than .001), and external attention deployment strategies (t = 4.08, P less than .001). No significant differences were found between faculty and staff in the use of exercise and physical activity or interactive self-regulation strategies. Higher-educated faculty women tended to use fewer SRS when compared with female staff (F = 4.70; df = 8.819; P = .0009). Faculty women were similar to faculty men in their use of SRS. Female staff used significantly more SRS when compared with faculty of both genders and male staff (t = 2.81, P = .05). Nursing implications of self-regulation nursing assessments are discussed in terms of nursing interventions and need for more research.

Adaptation, Psychological↗
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The art, science, and techniques of reframing in psychiatric mental health nursing.

Reframing is a powerful psychotherapeutic intervention. Changing the "frame" in which a person perceives events can change the meaning the person associates with the events. This article describes several types of reframing strategies that have been developed within the context of a model of human behavior and communication known as neurolinguistic programming (NLP). Fundamental assumptions of the NLP model are discussed and several reframing techniques are described. A set of strategies that clinicians can use to redefine behaviors and expand a client's model of the world are illustrated. Development of theoretical and clinical applications of the NLP model and reframing techniques in psychiatric-mental health nursing is an important task for the 1990s.

Communication↗