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Biomedical subjects

L M Janelli

Publications and source records attributed to L M Janelli.

27 records · Page 2Linked to original sources

Can a pulmonary health teaching program alter patients' ability to cope with COPD?

Many clinical nurse specialists (CNSs) are involved in providing group teaching programs for individuals with chronic obstructive pulmonary disease (COPD). Although knowledge levels often are enhanced by these programs, what is less well known is whether such programs also can affect the coping methods used by those with this disease. The exploratory study described here was part of a larger research project aimed at determining patients' knowledge, specific psychological parameters (anxiety, hostility, depression), and coping strategies. Thirty people agreed to participate in the study. The Jalowiec Coping Scale (JCS) (Jalowiec & Powers, 1981) was used so that participants could rate each coping method according to the degree of use and to determine whether the methods employed were affective or problem-solving approaches. There was very little change in the pre- and posttest scores on the JCS, indicating that there was little change in coping strategies used. There also were no significant correlations between the JCS scores and the demographic characteristics of age, educational level, and the length of time since diagnosis of COPD. The results of this study seem to indicate that pulmonary rehabilitation programs should place more emphasis on appropriate coping strategies that the COPD patient can incorporate into his or her lifestyle.

Adaptation, Psychological↗

What nursing staff members really know about physical restraints.

Although the use of physical or mechanical restraints is decreasing in long-term care facilities, there always will be some patients who require them. If a restraint is to be employed at all, it needs to be used correctly. A convenience sample of 118 nursing staff members who work in a county nursing home was asked to complete an 18-item knowledge questionnaire regarding restraint usage. Scores ranged from 6 to 17 (potential range 0-18), with a mean score of 13.2 (SD = 2.1). Overall, the staff's knowledge level can be considered good; however, there were some areas of concern. For example, a majority of the respondents (82.2%) believed that it was appropriate to keep a patient restrained lying flat in bed. Implications for administrators and rehabilitation nurse clinicians are identified.

Adult↗

Music intervention with physically restrained patients.

Lack of appropriate alternatives to the use of restraints in hospitals and rehabilitation settings is a major concern of nurses. The purpose of this pilot study was to determine the behavioral effects of music intervention with physically restrained patients. The results demonstrated that the number of positive behaviors increased significantly during the music-listening period, during which patients were not restrained, as compared to their typical restrained status. No differences were found that related to the number of negative behaviors displayed before, during, or after the music intervention. Listening to music of their own choosing may help produce positive behaviors in previously restrained patients; however, further studies are needed to confirm this.

Aged↗

Exploring music intervention with restrained patients.

Roy's Adaptation Model is used in a case study approach to begin examining the potential of music intervention in hospitalized, restrained patients. Restraints were removed during the time in which the patient listened to a musical tape through a headset. Mr. D, presented in this case study, was one of the 30 medical-surgical patients who participated. His observable positive behaviors increased from 10 during the preintervention period to 12 during the musical intervention. Mr. D displayed no negative behaviors during the entire study period.

Adaptation, Psychological↗

Acute/critical care nurses' knowledge of physical restraints--implications for staff development.

The use of physical restraints in acute care facilities has become a routine practice. Although nursing home settings have been federally mandated to reduce reliance on restraints, there has been no indication of a reduction in hospital settings. Staff development educators can provide guidance in the proper use of restraints. A total of 235 acute/critical care nurses from 17 states were asked to complete an 18-item knowledge questionnaire about the proper use and application of restraints. A majority (n = 142; 60.4%) had 13 of the 18 questions correct. The results suggest variability in knowledge about restraints due most likely from lack of information rather than misinformation. One hundred fifty-four nurses (65.6%) stated they were unsure about caring for a restrained patient. The authors describe implications of the study findings for nursing staff development and offer an outline for an inservice program on restraint use.

Adult↗

Restrained patients: an important issue for critical care nursing.

OBJECTIVE: To determine practice and attitudes of acute-critical care nurses toward the use of physical restraints. DESIGN: Survey with a self-administered anonymous questionnaire. SUBJECTS: A self-selected sample of 235 acute-critical care nurses from 17 states who were enrolled in critical care review classes. MEASUREMENTS: Data were gathered by use of a questionnaire developed by the researchers. The questionnaire was designed to elicit information regarding demographic and professional characteristics, nursing practice, and attitudes toward the use of restraints. Nurses responded to the practice items on a three-point Likert Scale as to whether they "always," "sometimes," or "never" carried out the procedure. To obtain information on attitudes, nurses were asked to respond on a three-point Likert Scale as to whether they "agreed," were "undecided," or "disagreed" with the statement. RESULTS: Responses indicated 78% of the sample "always" try alternative nursing measures before restraining the patient. However, when units were believed to be understaffed there was more reliance on restraints. Thirty-eight percent of the sample would "always" rather sedate patients than physically restrain them. The overall score on the attitude component of the questionnaire reflected positive or acceptable attitudes toward the use of restraints. Most (62%) "agreed" that a patient suffers a loss of dignity when placed in restraints. Significant relationships did exist between select demographic and professional characteristics and practice and attitudes regarding the use of restraints. The longer the respondents had worked in critical care the more appropriate (positive) their attitudes toward the use of restraints (r = -.211, p < .01). CONCLUSIONS: In general, nursing practice and attitudes regarding the use of physical restraints indicated that respondents were using restraints in accordance with accepted practice. There is a need for additional research in this area, especially regarding the use of alternative measures to physical restraints.

Adult↗