Biomedical subjects

Judith A Erlen

Publications and source records attributed to Judith A Erlen.

12 recordsLinked to original sources

PubMed2004

Complementary and alternative therapies in nursing curricula: a new direction for nurse educators.

The scope of nursing practice is expanding to include the use of complementary and alternative therapies (CAT). This expansion is occurring because of changes in professional and societal attitudes toward the use of such therapies. In this article, we discuss the use of CAT and the development of medical and nursing educational programs related to these therapies in Eastern and Western societies. In addition, we identify future directions for incorporating content on such therapies into nursing education programs in the United States. We suggest that undergraduate nursing programs need to introduce the philosophy of Oriental medicine and content on some of the common therapies and that graduate nursing programs that include content on the use of CAT in nursing practice can possibly be developed.

Complementary Therapies↗

PubMed2004

HIV disease susceptibility in women and the barriers to adherence.

The late 1990s saw a decrease in the total number of new cases of HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome). However, data often do not reflect the increased incidence of HIV in women, particularly women from minority groups. The purposes of this clinical review are to address the disease susceptibility and disease manifestations of HIV in women, and to discuss selected barriers to adherence to antiretroviral medications such as stigma, social support, and depression.

Antiretroviral Therapy, Highly Active↗

PubMed2003

Effects of acupuncture therapy on insomnia.

BACKGROUND: Acupuncture therapy, commonly used in clinical practice in oriental cultures, has the potential to produce a positive effect with patients experiencing insomnia. AIM: The purposes of this systematic review were: (1) to assess the trends across intervention studies using acupuncture for insomnia from 1975 to 2002, (2) to examine dependent variables, and (3) to evaluate the effects of acupuncture therapy on insomnia in older people. METHOD: Data were collected from November 2001 to January 2003. A wide range of electronic databases was searched using the keywords 'insomnia', 'acupuncture' and 'experimental design'. Papers were included if they were published in the English language between 1975 and 2002 and described an experimental study using acupuncture therapy to treat insomnia. Eleven reports met these criteria. FINDINGS: Most of the studies had been conducted since 1990. The findings showed that the first author was usually a Chinese medical doctor (n = 9) employed in a traditional department of medicine. Most of the papers were published in two journals: International Journal of Clinical Acupuncture and Journal of Traditional Chinese Medicine. Data were limited because of the small number of studies available. Half the studies had small samples (50 subjects or fewer), which were composed mainly of older women who had a variable duration of insomnia from 3 days to 34 years. The main method used to assess outcomes was questionnaire. All the studies reported statistically significant positive results. CONCLUSION: The results of this review suggest that acupuncture may be an effective intervention for the relief of insomnia. Further research, using a randomized clinical trial design, are necessary to determine the effectiveness of acupuncture. More work is also needed to promote the long-term therapeutic effects of acupuncture and to compare it with other therapies for insomnia.

Acupuncture Therapy↗

PubMedDate not supplied

Recruiting vulnerable populations for research: revisiting the ethical issues.

The successful recruitment of participants is essential to the research process. To increase the rate of subject participation, investigators have to rely on help from health care providers who often serve as gatekeepers to potential research study subjects. These well-meaning professionals may limit subject participation in a study involving vulnerable populations under the guise of protecting these individuals from harm. We describe some of the characteristics of vulnerable populations affecting their recruitment into research studies. We examine the ethical conflicts that occur when health care professionals control access to these subjects during recruitment for research studies. Finally, we discuss the implications for practice and research designed to protect the rights of vulnerable populations participating in research. We identify collaboration and dialogue between researchers, health care providers, and members of the potential subject populations as most important in recruiting sufficient numbers of subjects to ensure the scientific merit of the study.

Ethics, Research↗

PubMedDate not supplied

Adherence revisited: the patient's choice.

Adherence to treatment is an age-old issue in the health care provider-patient relationship. Although findings show that adherence has the potential to increase the efficacy of a treatment, is that the only consideration when examining the ethical questions surrounding adherence? What if the competent adult patient chooses not to adhere? The purpose of this paper is to examine the patient's choice to not adhere to a prescribed therapy. The author uses a hypothetical case as a way to identify and to challenge the assumptions underlying traditional adherence models.

Adult↗

PubMedDate not supplied

When there are limits on health care resources.

Controlling health care costs has been a goal within the health care system for nearly 40 years. Yet, what is occurring is that health care costs are actually increasing, and the quality of care is decreasing. Patients and health professionals are complaining that accessibility to services is limited. There are inadequate numbers of nursing staff to care for patients who are both sicker and have shorter lengths of stay. Patients are bewildered by a system that they find to be extremely impersonal and difficult to navigate. This article uses a hypothetical case to identify and examine some of the ethical issues related to access to health care within a managed care system. Recommendations for nurses are presented to help them meet the challenges of limited health care resources.

Cost Control↗

PubMedDate not supplied

When all do not have the same. Health disparities.

Eradicating health disparities and increasing health-related quality of life are the overall goals of Healthy People 2010. To achieve these goals requires that healthcare providers have an understanding of respect for individuals, trust, and implications of distributing resources equitably within society. The purposes of this article are to discuss health disparities and to briefly describe how ethics helps healthcare providers address health disparities. In addition, strategies that professional nurses can incorporate into their clinical practice in order to reduce health disparities are presented.

Ethics, Nursing↗

PubMedDate not supplied

Technology. Possibilities and pitfalls.

An amazing growing area in healthcare is the increase in the development of technology that is designed to augment human functioning and decrease an individual's dependence on others to provide personal care. Yet, what does it mean to extend a person's life through technology? Within the context of a hypothetical case, this article considers ethical questions raised by new and futuristic technologies designed to augment human functioning. These ethical issues are grounded within the context of the possibilities and the pitfalls of technology. When providing care to patients and families, nurses must recognize and understand the significant ways in which quality of life, personhood, accessibility, and cost may be challenged by the promises of new technologies.

Adult↗

PubMedDate not supplied

Caring doesn't end.

Despite the advances in healthcare technology and the new treatment regimens, all patients are not eligible for these treatments. Although some providers might indicate that there is nothing more that they can do, other healthcare providers do not give up on their patients and families. They continue to provide care, regardless of whether treatment options have been exhausted, and help these patients to have a "good death." The purpose of this article is to use two case examples to show how caring does not end but is rather transformed when intensive treatment ends. There is a discussion of the development of the hospice movement, upholding dignity and respect, and continuing to care. Recommendations for action that inform nursing practice are identified.

Aged↗

PubMedDate not supplied

Functional health illiteracy. Ethical concerns.

Functional health illiteracy is a silent disability demanding the attention of healthcare professionals because it affects millions of people in the United States. Patients are reluctant to disclose this problem because they fear discrimination and stigmatization. Inadequate health literacy raises ethical questions because it is a barrier to healthcare and results in poor health outcomes. The purposes of this article are to provide an overview of functional health illiteracy, identify related ethical concerns, and discuss selected, relevant nursing implications. Nurses are in a unique position to serve as advocates, mediators, and translators for their patients who are functionally health illiterate.

Adult↗

PubMedDate not supplied

Wanted-nurses. Ethical issues and the nursing shortage.

The persistent nursing shortage is challenging the values and beliefs of the nursing profession and causing nurses to ask how they can fulfill their ethical responsibilities to patients when there are an insufficient number and a maldistribution of nurses. Nurses are expressing job dissatisfaction, experiencing moral distress, and wondering about their inability to provide quality patient care. In this article, the author addresses the commitment to care for patients and the ethical dilemma with which nurses are grappling: caring for self versus caring for others. Recommendations for possible action include reenvisioning the profession of nursing, empowering nurses, providing support, and restructuring the work environment. Taken together, these actions have the potential to reduce the moral distress that nurses are experiencing and to enable them to honor their commitment to patient care.

Ethics, Nursing↗

PubMedDate not supplied

Adherence to antiretroviral therapy among women with HIV infection.

OBJECTIVE: The overall objective of this secondary analysis was to examine self-reported adherence to antiretroviral therapy in a sample of women with HIV. DESIGN: The primary study used survey methodology. SETTING: The setting included a university-based HIV/AIDS clinic in southwestern Pennsylvania and a community-based HIV/AIDS clinic in eastern Pennsylvania. PARTICIPANTS: Sixty-one women infected with HIV who were taking protease inhibitors. MAIN OUTCOME MEASURE: Self-reported adherence was based on responses to two questions: whether the person had missed a dose of her medications within the past 24 hours, and how many pills the person had taken on time as scheduled (none, very few, a few, about half, most, nearly all, all of them). RESULTS: Adherence ranged from 60% to 75%. Two thirds (65.6%) of the sample thought that their medications were helping them; three fifths (57.4%) thought that it was dangerous to miss a dose of their medications. CONCLUSIONS: Adherence in this sample was less than perfect, suggesting the need to develop, implement, and test interventions to promote better adherence to antiretroviral medication regimens among women with HIV.

Adult↗