Biomedical subjects

J Salyer

Publications and source records attributed to J Salyer.

24 records · Page 2Linked to original sources

PubMedDate not supplied

Patients' and their spouses' needs after total joint arthroplasty: a pilot study.

PURPOSE: To describe the experiences and needs of patients and their spouses during hospitalization and recovery from either total hip or total knee arthroplasty. DESIGN: Descriptive. SAMPLE: A purposive sample of 5 patients and their spouses in one health sciences center. METHODS: Qualitative study using a videotaped focus group interview. FINDINGS: Content analysis revealed two perspectives of one theme: patients and their spouses need "help making transitions." Situational and role transitions that were problematic for patients reflected distress over not being able to resume activities they enjoyed within an expected time frame. Incongruence between expectations and reality was the source of distress. As a consequence of role reversal, spouses experienced feelings of insecurity and being overwhelmed. Health and illness transitions that patients experienced were also related to incongruence between expectations of the recovery period and the reality that recovery is a slow process. Pain experienced during postdischarge recovery and rehabilitation, and problems encountered when applying information and skills learned in the hospital to the home setting were sources of concern. CONCLUSION: The needs and experiences of patients and spouses after total joint arthroplasty reflect transitional change--changes in roles, relationships, abilities, and behaviors. Health care professionals can facilitate transitions by providing education that reflects "best case-worst case scenarios" so that expectations of the recovery process are realistic. By being the link between hospital and home, health care professionals can lend support to patients as they continue the recovery process. As a program evaluation strategy, focus groups provide useful information to health care professionals who are interested in the needs and expectations of health care consumers. IMPLICATIONS FOR NURSING RESEARCH: Further exploration of the needs of patients and their spouses following joint replacement surgery is warranted. Use of focus group methodology might provide additional insight into the needs of this population and suggest ways in which health care professionals can modify existing programs to help these patients and their spouses make the transitions.

Adaptation, Psychological↗

PubMedDate not supplied

Predictors of early post-cardiac transplant exercise capacity.

BACKGROUND: This study was conducted to identify which pre- and perioperative clinical parameters were predictive of predischarge submaximal exercise capacity and early postdischarge maximal exercise capacity in cardiac transplant recipients. METHODS: We studied 24 patients (mean age = 46; 25% African American) who underwent cardiac transplantation followed by an early (immediately posttransplant) postoperative exercise training program. The patients' submaximal exercise capacity was measured at hospital discharge (25 days posttransplant) using the 6-minute distance walk test. Maximal cardiopulmonary exercise testing was done within 4 months of hospital discharge (68 days) to measure peak exercise oxygen consumption (VO2) and to estimate peak exercise capacity as measured by metabolic equivalents (METs). Six clinical variables were assessed for their relationship with predischarge submaximal exercise capacity and 10 clinical variables were evaluated for their relationship with early posttransplant maximal exercise capacity. RESULTS: Predischarge submaximal exercise capacity was correlated with postdischarge estimated METs (r = 0.43; P = 0.04). No predictors of predischarge submaximal exercise capacity were identified. Predictors of estimated peak exercise METs following discharge were younger age, longer time since resolution of rejection, and shorter postoperative hospitalization. Younger age was the only predictor of peak VO2. CONCLUSION: Postoperative physical training may improve exercise capacity early after transplantation and minimize effects of preoperative clinical factors that could negatively affect exercise capacity. Interpretation of these results, however, is limited by the small sample and absence of a nonexercising control group. Older recipients, those with a longer length of hospital stay, and shorter duration of time since resolution of rejection may be at risk of reduced early postoperative maximal exercise capacity. Identification of these predictors is important to maximize early reconditioning efforts and plan outpatient rehabilitation.

Adult↗

PubMedDate not supplied

Psychosocial self-efficacy and personal characteristics of veterans attending a diabetes education program.

PURPOSE: The purpose of this descriptive correlational study was to describe the perceived psychosocial self-efficacy, attitude toward having diabetes, baseline glucose level, and personal characteristics of male veterans with type 2 diabetes. METHODS: The Diabetes Empowerment Scale (DES) was mailed to participants and collected on the day of the program. Percent ideal body weight and glycosylated hemoglobin were measured. Comparisons were made by educational level, racial origin, and type of medication regimen on the DES and its subscales. RESULTS: Participants on oral medication versus insulin had higher scores in the categories of Motivation to Change and Ability to Cope with Feelings. Participants with less education had greater scores in Ability to Cope with Feelings and Obtain Support. No racial differences were seen on the measured scores; a significant difference was seen between Caucasians and non-Caucasians in baseline glycemic control. CONCLUSIONS: Targeting intervention strategies early in the course of disease progression may positively affect outcome. Longitudinal studies are needed to demonstrate the impact of self-management training on psychosocial self-efficacy and clinical outcomes.

Adaptation, Psychological↗

PubMedDate not supplied

The Outcomes Research in Nursing Administration Project: methodological issues in implementation.

This article describes the Outcomes Research in Nursing Administration (ORNA) project--a longitudinal, multisite study investigating the interrelationships of various hospital-level and nursing-unit-level characteristics, nursing unit organizational structure, and administrative and patient outcomes. A variety of methodological challenges were encountered in the actual conduct of the project in relation to the design, sampling plan, management of attrition, and data collection. The article describes these challenges and how they were successfully resolved.

Data Collection↗

PubMedDate not supplied

Strategies to enhance internal validity in multi-center longitudinal research.

Lack of standardized data collection procedures in multi-center longitudinal research poses potential threats to the internal validity of the study. This article addresses several key issues in data collection that can affect the results of longitudinal research. The authors describe these issues in relation to the study currently in progress and cite specific strategies used during data collection to reduce or eliminate data collection inconsistencies. Use of these strategies is not limited to longitudinal, nonexperimental causal models. Outcomes managers and clinical nursing researchers may find some of the strategies useful to enhance the internal consistency of experimental and nonexperimental cross-sectional research.

Bias↗

PubMedDate not supplied

Methodological issues in treatment effectiveness and outcomes research.

The authors define treatment effectiveness and outcomes research, then discuss three critical methodological issues that if not appropriately resolved, can invalidate the findings of such studies. The three issues are research design, comparability of treatment groups, and approaches to measurement. These issues must be considered when the quality and contribution of findings from treatment effectiveness and outcomes research are evaluated.

Data Interpretation, Statistical↗