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Biomedical subjects

L C Pugh

Publications and source records attributed to L C Pugh.

At least 19 recordsLinked to original sources
PubMed1999

Partners in care: a model of collaboration.

It is estimated that 3 million persons in the United States have congestive heart failure. This diagnosis accounts for more than 5% of total health expenditures. A method to decrease the costs of health care was initiated through the partners-in-care model of collaborative practice. A research study exploring the use of nurse case managers in collaboration with cardiologists and primary care physicians is being conducted with persons older than 65 years. This care encompasses both inpatient and outpatient care. The intervention comprises nurse visits in the hospital and in the home as well as telephone support for 6 months after the index hospitalization. The outcomes of quality of life, functional status, mortality, morbidity, and costs are being examined. Collaborative health care partnerships may be an effective strategy to decrease health care costs and improve quality of life and functional status of older persons with congestive heart failure.

Aged↗
PubMed1998

The fatigue experience: persons with HIV infection.

Fatigue is a frequently reported symptom by persons with HIV infection and one that has an adverse impact on activities of daily living and overall quality of life. Although the concept of fatigue has been studied extensively and discussed in the literature, little is known about the experience of fatigue by persons with HIV infection. A hermeneutic phenomenological study was conducted to investigate the subjective experience of HIV-associated fatigue and to describe the management of fatigue in the context of daily life. In-depth interviews were done with 10 adult patients of an outpatient HIV/AIDS clinic. Thematic analysis identified three concerns that represented the meaning of fatigue for the participants. The first concern was 'Fatigue as a signal of AIDS'. A second concern was 'The mind, the body, the social experience of fatigue'. The third concern was 'Choosing ways to live with fatigue and addiction'. The findings provide insights for nursing practice regarding the subjective meaning of fatigue for patients with HIV and the need for nurses to explore this topic with patients.

Activities of Daily Living↗
PubMed1998

First stage labor management: An examination of patterned breathing and fatigue.

BACKGROUND: Patterned breathing is one way that women cope with labor. Fatigue is a frequently reported symptom over which women and caregivers have little control. The purpose of this study was to examine the relationship between the use of patterned breathing, a traditional intervention, and the level of fatigue reported during the first stage of labor. METHOD: A secondary analysis was conducted on a subset (n = 56) of a prospective longitudinal study of fatigue during the intrapartum period. The sample comprised primiparous women in labor whose fatigue was measured every two hours for six hours after admission. At each data point the investigator evaluated the method of breathing that participants used. RESULTS: During the latent phase of labor, women using patterned breathing exhibited significantly more fatigue. In the active phase, differences between groups were not significant. Controlling for age, education, and marital status of participants did not change the results. CONCLUSIONS: It is appropriate for nurses, midwives, physicians, and doulas to encourage the use of patterned breathing as an intervention in active labor; however, patterned breathing may increase the mother's fatigue level if begun too early.

Adaptation, Psychological↗
PubMed1998

Side effects of alternative iron supplementation: a pilot study.

Iron deficiency anemia is a significant health problem for women. An intervention utilizing home visits by a nurse and the intake of alternate iron supplements was examined. Outcome measures of hematocrit levels and side effects are reported in this manuscript. Ten African-American inner city homeless women in transitional housing agreed to participate in this longitudinal study. Each participant was encouraged to take the alternate iron supplements for a three month period. Hematocrit values increased from recruitment through the third month. A paired t-test was significant (t value -5.39; df, 9; p < .0001). In addition, the side effect of fatigue decreased from recruitment through the third month. A paired t-test was significant (t value 3.18: df, 7: p = .015). During the weekly and monthly visits, when the subjects were asked if the supplements had any effect on their feelings of well-being, two women stated they had "little effects." In terms of side effects there were no complaints of nausea, stomach ache, or black tarry stools. Of the approximately 12 visits to each subject, constipation was reported only two times by two subjects. While the women did not report black stools they did offer that the vitamins seemed to color their stools green (three reported it one time and two subjects reported it three times). The benefits and the lack of side effects may have far-reaching implications for client populations such as the elderly and pregnant women who typically have difficulty with anemia and constipation alike. The weekly visits by the nurse may have added to the compliance and success of this program.

Adolescent↗
PubMed1997

The middle-range theory of unpleasant symptoms: an update.

A detailed description of the newly revised and updated theory of unpleasant symptoms is provided. Revisions have resulted in a more accurate representation of the complexity and interactive nature of the symptom experience. Examples are provided to demonstrate the implications of the revised theory for measurement and research, and its application in practice. A detailed exemplar describes how it guided the design of a multifaceted intervention to encourage successful breastfeeding.

Activities of Daily Living↗
PubMed1996

Positioning intervention to minimize fatigue in breastfeeding women.

Nursing interventions to enhance breastfeeding affect the health of mothers and babies. Fatigue may interfere with breastfeeding, so interventions minimizing fatigue are important. This repeated measures study of 20 postpartum women investigated the relative efficacy of one intervention, promoting use of the side-lying position. Using the Modified Fatigue Symptoms Checklist, fatigue was measured after breastfeeding in two positions. In mothers who had vaginal deliveries (n = 14), significantly less fatigue was reported following nursing in the side-lying versus the sitting position. Instruction regarding restfulness of the side-lying position should be considered as part of routine postpartum or home health nursing care.

Adult↗
PubMed1996

A comparison of topical agents to relieve nipple pain and enhance breastfeeding.

BACKGROUND: Nipple soreness is one reason why breastfeeding women wean their infants. This study examined the effectiveness of three topical agents--USP-modified lanolin, warm water compresses, and expressed breast milk with air drying--in alleviating nipple pain, and if early predictors of breastfeeding at six weeks could be determined. METHODS: One hundred seventy-seven breastfeeding, primiparous women were randomly assigned to one of four groups. All women received education about breastfeeding technique. Numeric rating scales were used to discriminate levels of pain intensity, pain affect, and strength of sucking on day 1. Participants were interviewed by telephone on postpartum days 4, 7, and 14, and during week 6 using the same scales. RESULTS: No significant differences were found among groups for pain intensity, pain affect, or duration of breastfeeding. Results of a logistic regression indicated that older mothers and those who were exclusively breastfeeding (no supplemental feeding) were most likely to be breastfeeding six weeks postpartum. Raw scores supported the use of warm compresses. CONCLUSION: Further investigation is required into ways of supporting young mothers and how caregivers provide support to breastfeeding mothers in the early weeks after childbirth.

Administration, Cutaneous↗
PubMed1996

Pregnancy after cardiac transplantation: principles of nursing care.

The number of cardiac transplants for chronic end-stage disease, congenital heart disease, and primary pulmonary hypertension has increased during the past 20 years. Decreased symptoms, decreased incidence of rejection, and greater tolerance of medical regimens have improved the quality of life for heart transplant recipients. Women of childbearing age who have undergone cardiac transplantation may now consider pregnancy. The principles of nursing care for pregnant women who have undergone heart transplantation are presented in this article. A case report of pregnancy after cardiac transplantation is included.

Adult↗
PubMed1996

Postpartum fatigue: clarifying a concept.

This paper describes the multifaceted approach employed to clarify the concept of postpartum fatigue. The process began with a literary analysis, which gave rise to questions about the defining characteristics of postpartum fatigue and its differentiation from related concepts such as tiredness and depression. A series of qualitative and quantitative studies were carried out to examine new mothers' characterizations of their fatigue, the indicators and predictors of postpartum fatigue, and the differences between fatigue and depression. The evolving concept clarification suggests that postpartum fatigue is most effectively conceptualized as a multidimensional concept with physical and mental aspects that is different from tiredness and can be differentiated from postpartal depression or milder "baby blues," with which there is some overlap.

Concept Formation↗
PubMed1995

Collaborative development of middle-range nursing theories: toward a theory of unpleasant symptoms.

One promising approach to strengthening theory-research and theory-practice linkages is to place greater emphasis on developing and using theories of the middle range to underpin nursing research and practice. In this article, a postpositivistic definition of middle-range theory is advanced, an argument is made for shifting nursing's theory development activities from discipline-defining grand theories to middle-range theories, and a collaborative and incremental approach to middle-range theory development is described and illustrated. A sustained substantive example is provided by the beginning development of a theory of unpleasant symptoms.

Dyspnea↗
PubMed1995

Use of physiologic variables in nursing research.

In this study, the use of physiologic variables is described in research reports published 1989-1993 in four broad-based research journals. The National Institute for Nursing Research (NINR) emphasizes the need for more physiologically based nursing research. This analysis documents the current number and proportion of such research reported in four journals during a 5-year period. Each report was evaluated for the population sampled, type of physiologic variable, type of study, definitions, and reporting of reliability and validity measures. Among the 763 reports, 114 (15%) examined physiologic variables. The most frequently studied physiologic variables were blood pressure, heart rate, and body temperature. The majority of studies posed and answered a clinical nursing question, and the study populations sampled were adults. Theoretical and operational definitions were included in most reports. Evidence of reliability and validity analysis were in 36% and 60% of the reports respectively. Although most nursing research focuses primarily on psychosocial aspects of care, several conceptual and psychometric issues were also addressed in studies that examined physiologic variables.

Clinical Nursing Research↗
PubMed1994

Comfort measures in breastfeeding, primiparous women.

OBJECTIVE: To examine various comfort measures and evaluate their effects in alleviating nipple soreness. DESIGN: Prospectively randomized, experimental study. SETTING: Postpartum unit of a community teaching hospital. PATIENTS: Seventy-three primiparous, postpartum, breastfeeding women. INTERVENTIONS: Subjects were randomly assigned to four groups, with all women receiving instruction about breastfeeding and using one of the following treatments: warm moist tea bag compress, warm water compress, expressed milk massaged into the nipple and areola and air dried, instruction only (control group). The subjects completed a questionnaire each morning for 7 days regarding nipple soreness. MAIN OUTCOME MEASURE: Effect of treatments on postpartum nipple pain. RESULTS: Subjects in the warm water compress group demonstrated significantly less pain on Day 3 than did the tea or breast milk group. CONCLUSIONS: Anticipatory guidance by obstetric nurses may assist breastfeeding women in treating their pain nonpharmacologically.

Adult↗
PubMed1993

A framework for the study of childbearing fatigue.

Accounts of fatigue in childbearing women are identified in clinical reports, maternity textbooks, and studies. However, limited conceptual clarification or empiric research directed at mothers' fatigue during childbearing has been undertaken. To better understand fatigue, factors in the childbearing woman's life that are thought to predispose her to fatigue were identified; also delineated were the potential effects of fatigue on maternal performance. The framework that emerged, representing insights from childbearing and fatigue literature, is designed to serve as a guide to research that will add to understanding of childbearing fatigue and how it can be prevented or ameliorated.

Adult↗
PubMed1993

Childbirth and the measurement of fatigue.

Fatigue during labor concerns women and nurses alike, yet few studies have directly measured fatigue during childbirth. Many issues and difficulties with the conceptualization and measurement of fatigue have been raised because of the multidimensionality of the concept. Fatigue was conceptualized as including subjective, cognitive, and physical dimensions, and was therefore operationalized using multiple methods. In the two studies described, fatigue was measured using the Modified Fatigue Symptom Checklist (MFSC), the Pearson-Byars Feeling Checklist (PBFC), Visual Analogue Scales (VAS), the Digit Span Subtest of the Wechsler Intelligence Test (revised R), and a hand held bulb dynamometer. These studies support the reliability and validity of the measures used to quantify fatigue during labor. These findings support the operationalization of fatigue as a multidimensional concept.

Adult↗