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Biomedical subjects

K Moore

Publications and source records attributed to K Moore.

297 records · Page 17Linked to original sources

Posttraumatic stress disorder in the orthopedic patient (continuing education credit).

Our clinical experience indicates that the incidence of PTSD in orthopaedic patients is higher than is described in the literature. Patients such as Karen, Jim and Bill are not uncommon. All individuals who experience an immensely stressful event are at risk for developing this complex response. Orthopaedic nurses must be knowledgeable about the multifaceted nature of the post trauma response, since they are in a key position to recognize its symptoms, participate in treatment, and facilitate individuals' return to a pretraumatic state.

Adolescent↗

The magic shop.

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Adult↗

Domestic violence: are we listening? Do we see?

This article reports on a study of female victims of abuse who had been hospitalised for treatment of injuries inflicted by their spouses. A phenomenological approach was adopted wherein four women were interviewed to elicit their perceptions of their last hospital experience. Four major themes emerged from analysis of the interview data, these were that the women consistently experienced: disengagement and loss of status; disempowerment and lack of control; stigma and social isolation and a sense of being misunderstood. The results of the study are discussed in relation to women's expectations of nurses' attitudes and nursing interventions.

Attitude to Health↗

Twenty four-hour monitoring of incontinence and bladder function in a community hospital.

We wished to determine whether 24-hour monitoring of urinary incontinence without video urodynamics would provide adequate information for treatment. Twelve subjects with urinary incontinence (seven women and five men) were investigated, average age 75 years (range 44 to 89 years). Setting was a community hospital (80 beds), a nursing home, and a lodge, 60 miles from the nearest assessment center. Twenty four-hour monitoring consisted of 2 hourly preweighed pad changes, postchange weighing, Uroflow set-up in subject's bathroom, fluid intake record, and 1 postvoid residual ultrasonogram. All subjects had history and physical and evaluation of medications. Findings included probable urge incontinence, stress incontinence, chronic retention with overflow, and normal bladder function. Recommendations included oxybutynin chloride, timed toileting, timed fluid restriction, diuretic manipulation, intermittent catheterization, pessary, and surgery. At 6 weeks, 25% (4/12) were better (three with urge incontinence and one after operation for stress incontinence). Video urodynamics were conducted only for the patient with stress incontinence after operation. We suggest that 24-hour monitoring is noninvasive, is less disruptive and less expensive than video urodynamics, and provides adequate information for initial treatment in many patients with urinary incontinence.

Adult↗

A study of discomfort and confusion among elderly surgical patients.

Acute confusion is a significant problem among elderly surgical patients, and it can impair the older adult's ability to localize, interpret, or communicate discomfort to care-givers. Discomfort is a common experience for hospitalized older adults, especially those recovering from trauma or surgery. In this study, 36 (78%) of the elderly (> 74 yrs.) patients on an orthopedic/trauma unit were found to be at risk for or acutely confused. Three measures of discomfort were administered to these 36 confused patients by research assistants during routine postoperative nursing activities, such as turning, transfers, or bathing. Acute confusion needs to be viewed as a priority problem for nurses working with elderly surgical patients. Self-report is not a reliable indicator of discomfort in elderly confused patients. It is recommended that health care providers focus on discomfort as they provide care to these elders, and intervene in a preventive fashion.

Acute Disease↗

Socioeconomic status as quarantine: unfortunate consequences of the inability to afford health care.

Socioeconomic status is a powerful determinant of health care outcomes. Affordability of health care probably has more effect on the treatment patients receive than do clinical factors or practitioner expertise. This article reviews and displays the research base for aspects of socioeconomic factors and measurement issues and their impact on outcomes. A strong and consistent relationship between socioeconomic factors and outcomes challenges nurses to find strategies for working effectively with vulnerable populations. The documentation of discrepancies in outcomes provides evidence of domains in which clinicians and policy makers can have measurable impact.

Health Services Accessibility↗

Young women's degree of control over first intercourse: an exploratory analysis.

CONTEXT: While policymakers and researchers alike often seem to believe that young women's decision to initiate sexual intercourse is conscious and free of ambiguity, the actual degree of control that such young women exert over first intercourse has rarely been explicitly examined. METHODS: The 1995 National Survey of Family Growth asked all women who had experienced intercourse to rate, on a 1-10 scale, the wantedness of their first intercourse; they were then asked whether the experience was voluntary. Logistic regression analysis of data for women aged 15-24 who had experienced first premarital intercourse was performed to test the effect of background factors and wantedness scores on contraceptive use at voluntary first intercourse. RESULTS: Twenty-four percent of women aged 13 or younger at the time of their first premarital intercourse report the experience to have been nonvoluntary, compared with 10% of those aged 19-24 at first premarital intercourse. About one-quarter of respondents who reported their first intercourse as voluntary chose a low value (1-4) on the wantedness scale. Women whose first partner was seven or more years older than themselves were more than twice as likely as those whose first partner was the same age or younger to choose a low value (36% vs. 17%). Women whose partner had been seven or more years older were also less likely than other women to have used contraceptives at first intercourse. After the introduction of controls for demographic and background factors, partner age discrepancy and relationship status, wantedness of voluntary first intercourse was not independently related to the odds of contraceptive use at that intercourse. CONCLUSION: Characterizing women's first intercourse as simply voluntary or nonvoluntary is inadequate. Measures that take into account degrees of wantedness may help elucidate relationships between sexual initiation, contraceptive use and teenage pregnancy. The fact that substantial numbers of young women voluntarily participated in a first sexual experience about which they felt ambivalent or negative deserves the attention of program planners and service providers.

Adolescent↗

Weigh the evidence.

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Evidence-Based Medicine↗