Biomedical subjects
J Mallett
Publications and source records attributed to J Mallett.
A study to ascertain gynaecological patients' perceived levels of embarrassment with physical and psychological care given by female and male nurses.
The Sex Discrimination Act lifted the barriers which prevented men from training and practising as midwives. However, cultural attitudes perceive nursing to be a female profession, and whilst care from a male doctor is considered to be acceptable, care from a male nurse is said to be embarrassing. The purpose of the study was to identify if there was any relationship between the intimacy of a nursing interaction and the patient's level of embarrassment. Data collection was by questionnaires with rating scales. Demographic data was obtained from nursing and medical notes. Statistical analysis was performed by non-parametric methods using Mini-tab. Ninety-one questionnaires were returned from a convenience sample of patients on a gynaecological oncology ward. Analysis of the data indicates that in a population of patients who have no prior experience of hospital admission, or of being cared for by a male nurse, there is a preference for care by a female nurse. However, this preference is not demonstrated in patients who have undergone previous hospital admission within the last five years or who have been cared for by a male nurse. These findings would indicate a cultural preference for care by a female nurse in patients with gynaecological cancer that is changed by experience during hospital admission.
Protocols and guidelines for managing wounds.
The management of a chronic wound is aimed at symptom control and maintaining the individual's quality of life. Wound-care guidelines will promote a co-ordinated and systematic approach to wound management. The administration of wound-care products according to protocol can enhance the care of patients with complex chronic wounds.
Comparative distribution and use of humour within nurse-patient communication.
There has been increasing interest in the use of humour in patient care within recent years. However, little research has been conducted to show the natural utilisation of humour, particularly from the participants' perspective, within the clinical environment. This study uses ethnomethodological ethnography and conversation analysis methods to investigate the use of humour between nurses and patients with renal failure who were learning about, and to, haemodialyse. It is believed that the project is unique in the utilisation of audiovisual video recordings to measure and describe the frequency, distribution and use of humour. Findings indicated that humour rates and the proportion of humour produced by the patients were differentially distributed between patients but, overall, not between the same patients on different occasions. In addition, in one case a significant positive relationship between the rate of humorous instances per session and time was demonstrated and another patient (D) was found to produce a significantly larger proportion of the humour over time. Further exploration of patient D's increasing use of humour revealed that one important aspect was associated with the patients anxiety and difficulties with regard to "needling'. The findings have implications for understanding the role of humour in health care communication, particularly with reference to developing formal "humorous interventions'.
Humour and laughter therapy.
There is much anecdotal 'evidence' from nurses and patients to support humour and laughter as therapy. However, there is little research to support specific humour or laughter interventions as beneficial in the short or long term in the clinical environment. Humour and laughter remain potentially exciting and innovative tools for nursing therapy. They have a number of effects which could prove beneficial for many different nursing and medical diagnoses and appear to have the additional advantage of being adaptable to most situations. More clinical evaluation of humour and laughter therapy is required before its appropriate use can be defined.
Shifting the focus of audit.
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Preliminary report of the Colorado School Vision Screening Interdisciplinary Task Force.
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Communication between nurses and post-anaesthetic patients.
This paper explores the verbal and non-verbal communication between nurses and post-anaesthetic patients in the recovery unit of an inner London hospital. Although the patients had only minor operations the study findings and the method of conversation analysis provide ideas which could have wider relevance in intensive care. A video camera was used to record nurses' conversations with dental patients recovering from their operations. The resultant tape was studied for the utterances and body movement used by the nurses in order to engage the patient in conversation. Analysis indicated that the nurses were skilled communicators who took into account the patients' low level of consciousness and lack of physical orientation when initiating and maintaining interaction. This is an important factor in the care of post-anaesthetic patients, as the recovery nurse may need to gain the patient's attention to converse with him for a variety of reasons, including safety and the need to orientate the patient to his environment in order to reduce anxiety (Mallett, 1986). The ability of the nurse to communicate successfully is, therefore, one of the prerequisites for adequate nursing care in the Recovery Unit. In addition, the notion of therapeutic communication as a separate entity to skillful conversation is raised.
Triage in accident and emergency departments.
This study was carried out to investigate the effect of triage on attenders' waiting times in an accident and emergency (A & E) department. The A & E department comprised three separate areas: the A & E unit, dressing clinic and review clinic. Data on all A & E attenders were collected by the nursing staff over a period of 1 week using a data collection form. The waiting times for the attenders to be seen by a doctor in 1988 were longer than in 1986. This may partly reflect the lower number of people using A & E in 1986, while the current practice of an initial triage assessment may slow the patients' access to a doctor. This latter finding is a cause for concern, since the receptionist is the main triage assessor at night. However, the time the attender spent waiting to be clinically assessed by a health care professional (nurse) was shorter in 1988 than when performed by a health care professional (doctor) in 1986. This indicated that nurse triage enabled a shorter waiting time between arrival and assessment of the A & E unit attender.
Effects of chronic developmental lead exposure on monkey neuroanatomy: visual system.
The effects of lead on specific areas of the visual system were examined in two groups of monkeys (Macaca fascicularis). The first group (N = 3) received 2000 micrograms Pb/kg/day from infancy onward, while the second group (N = 4) received 25 micrograms Pb/kg/day from birth onward. Monkeys were killed at approximately 6 years of age. Areas of the visual system, including optic nerve, lateral geniculate nucleus, and primary area V1 and one visual projection area V2, were examined by a combination of light and electron microscopy and Golgi impregnation. No effect of lead on optic nerve was identified, nor were there consistent differences in the lateral geniculate nucleus. Within areas V1 and V2, the neuronal volume density was significantly reduced in the high dose compared to the low dose group. Moreover, analysis of the dendritic arborization by Golgi analysis revealed a relative decrease in the number of arborizations among pyramidal neurons in both areas V1 and V2. These data suggest that lead exposure beginning during the early postnatal period may result in changes in cytoarchitecture in visual areas V1 and V2.
A comparison of the Cyprane and Samson nasal mask scavengers during relative analgesia.
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Nitrous oxide sedation in dentistry. A comparison between Rotameter settings, pharyngeal concentrations and blood levels of nitrous oxide.
Nitrous oxide concentrations (V/V) at the delivery Rotameters block, nasal mask, pharynx and venous blood, were compared. There was a dilution of approximately 50% of the delivered nitrous oxide at the nasal mask which was further reduced in the pharynx. Venous blood concentrations 10 minutes after inhalation of nitrous oxide were low but as would be calculated from pharyngeal concentrations. After 5 minutes of oxygenation venous blood nitrous oxide concentrations were still relatively high. A total of 92% of subjects experienced a satisfactory effect with 30% nitrous oxide or less in the pharynx.
Danazol in the treatment of vesical endometriosis.
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Comparison of three anaesthetic scavenging devices using cuffed and noncuffed nasal endotracheal tubes during dental anaesthesia.
During maxillofacial and oral surgery the effect of three anaesthetic scavenging devices used with cuffed and non-cuffed endotracheal tubes was investigated. All the devices produced reductions in nitrous oxide concentrations in the breathing zone and peripheral air, ranging from 36% to 76%. Of the three devices evaluated, the Stellenbosch valve produced the greatest reduction in pollution compared with the control.
Implementation and documentation of active programming in a residential facility.
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Classification behaviors in third and sixth grade lower and middle socio-economic status school children.
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Use of humour and laughter in patient care.
Research into humour and laughter has indicated that these have psychological, social and physical effects which may have useful applications for patient care. Humour and laughter are potentially useful therapeutic tools but, as yet, little clinical research into their utilization or efficacy has been conducted in the UK.
Lessons from the experience of using a video camera for research.
This paper discusses the practical and theoretical issues associated with the use of video cameras in a field setting to collect data of nurse-patient communication. In particular, the advantages and difficulties of filming participants are addressed and strategies put forward for overcoming potential problems. This paper aims to provide a useful insight into the use of these methods for other researchers.