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Biomedical subjects

M C Corley

Publications and source records attributed to M C Corley.

29 records · Page 2Linked to original sources
PubMedDate not supplied

The nurse's multiple commitments.

Nurses have multiple commitments: organizational, work, professional, job, patient, and personnel. Research has focused almost exclusively on organizational commitment and, to a lesser extent, on professional and job commitment. This fragmented approach to the study of the nurse's commitments neglects the nurse's commitment to patients. The concept of commitment needs to be clarified so that knowledge derived from research on commitment enhances our understanding of how nurses manage these multiple commitments.

Clinical Competence↗
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Lifestyle and health status in long-term cardiac transplant recipients.

OBJECTIVE: The purpose of this pilot study was to describe the lifestyle and health status of long-term cardiac transplant recipients. DESIGN AND SETTING: The study was a descriptive correlational design at a health sciences center. MEASURES: We measured lifestyle, using the Health-Promoting Lifestyle Profile-II, and indicators of health status (eg, number of medications, infections, and rejections; systolic and diastolic blood pressure; lipid profile; and percent ideal body weight) in 47 patients after an annual evaluation or follow-up visit after patients received cardiac transplantation. RESULTS: Patients were primarily male, white, 56.5 years old and 75.6 months after transplant. Spiritual growth was the most frequently reported lifestyle characteristic (mean, 27.4; SD, 4.9). The least frequently reported lifestyle characteristic was engagement in physical activity (mean, 18.4; SD, 5.7). Factorial between-subjects analysis of variance demonstrated that women had a higher high-density lipoprotein level (P =.0001) and reported healthier dietary habits (P =.02) and greater spiritual growth (P =.006) than men. African Americans reported poorer stress management behaviors (P =.04). Recipients whose heart failure was due to ischemic cardiomyopathy had a lower percent ideal body weight than those with a nonischemic cause (P =.01). Recipients with cardiac allograft vasculopathy had a higher low-density lipoprotein cholesterol level (P =.05) and lower high-density lipoprotein cholesterol level (P =.05) than those without cardiac allograft vasculopathy, and those persons who required maintenance corticosteroid therapy reported poorer interpersonal relationships than those persons not receiving corticosteroids (P =.04). CONCLUSION: Cardiac transplant recipients did not consistently include health-promoting behaviors in their lifestyles although some of the behaviors were associated with a better health status. Future research should be aimed at identifying factors that affect the ability to make and sustain changes in lifestyle and improve health status.

Adult↗
PubMedDate not supplied

Prevalence of principled thinking by critical care nurses.

The advanced technology surrounding the nursing care of the acutely ill patient has precipitated many ethical issues. The first step in understanding how nurses respond to these ethical issues is to become familiar with their moral reasoning and use of ethical principles in making decisions. This research report describes the responses of critical care nurses to six vignettes of the Nursing Dilemma Test as a measure of their use of principled thinking to decide on actions in specific ethical situations. Nurses used principled thinking more often to respond to ethical situations than purely practical responses.

Critical Care↗
PubMedDate not supplied

Techniques in evaluating nursing expert systems: A case study.

This study addresses the problems in evaluating nursing diagnostic artificial intelligence (AI) expert systems. Two separate experiments (N = 49) were conducted using a computer expert system. The first experiment, the "white box" experiment (n = 9), compared the diagnostic techniques applied by experience RNs against the programmed techniques used by the expert system. The second experiment, the "black box" experiment (n = 40), compared diagnostic results of beginning nurses against the computer expert systems results. In some cases the computer outperformed the nurses and vice versa. The evaluation techniques, as applied in both experiments, enhance the ability of nurses to evaluate and select AI expert systems to be used in computer-assisted diagnosis of nursing problems.

Clinical Competence↗
PubMedDate not supplied

The role of nursing in a support group for heart transplantation recipients and their families.

Heart transplantation, an increasingly accepted intervention to prolong life, involves specific nursing interventions, not only in the area of patient physical care but also in areas of health teaching and psychosocial assessment. This study discusses data collected from a support group created in September 1984 for heart transplant recipients and their families. The major concerns of patients and families were identified and translated into implications for nursing care. Fourteen sessions were voice-recorded and analyzed, identifying common, recurring topics. A total of 24 potential candidates for transplantation and recipients, ranging in age from 19 to 52 years, and eight wives participated in at least one of the weekly sessions. The average attendance per session was eight patients and three wives. The major areas of concern related to; health maintenance, role-relationships, self perception/self concept, values/beliefs regarding health, and coping/stress tolerance. Preoperative patients had greater concern for health maintenance, whereas patients in the post-transplant period were more concerned about role-relationships, sexual function and activity-exercise patterns. Nursing implications in these areas included in-depth health teaching about procedures, medications and their side effects, self-care regarding signs and symptoms of infection or rejection, and dietary requirements and limitations. Other aspects involved psychosocial adjustments following discharge from the hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
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A patient satisfaction measure as a criterion to evaluate primary nursing.

The Risser Patient Satisfaction Scale was used to evaluate the effectiveness of implementing the key concepts of primary nursing. An experimental control design was used. Forty-six subjects from two units completed the questionnaire. Estimates of reliability and homogeneity are reported. There is reason to question the discriminant validity of the subscales. No significant differences were obtained between the units on any of the subscales or total scale score. A number of explanations are offered for interpreting the measuring of the nonsignificance of the differences. Work need to continue on revising existing patient satisfaction measures or developing new ones. Other criteria with theoretical importance should be used in conjunction with satisfaction measures in assessing the effects of primary nursing.

Consumer Behavior↗
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Criteria in the selection of organ transplant recipients.

The purposes of this article are to describe the criteria used to select organ transplant recipients, to highlight the similarities and differences in these criteria, and to review the findings that support these criteria. Reports on criteria used in selecting heart, lung, liver, pancreas, and kidney recipients were reviewed in addition to reports on proposed approaches to allocating scarce health care resources. The conclusions are that criteria used for organ transplant recipient selection (other than medical criteria related to the diseased organ) vary from setting to setting, organ to organ, and are modified over time. No universal system has been adopted to guide recipient selection.

Contraindications↗
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Loading a nursing expert system from text: a case study.

A major bottleneck in the construction of expert systems has traditionally been the solicitation and formalization of expertise from the "human expert." As a means of reducing this bottleneck, the authors propose the use of "text" as a source of knowledge. Acquisition of knowledge from text has not been successful thus far, primarily because most text is not presented in a format (rules, frames, or logic) that can be directly used to load a knowledge base. The authors propose techniques to overcome these inherent problems. This article introduces a model for building an expert system that relies on "text" as the source of knowledge. The model is introduced via a case study involving the building of a nurse expert system designed to replicate the medical diagnostic activities of professional nurses.

Artificial Intelligence↗
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Nurses' ability to achieve hyperinflation and hyperoxygenation with a manual resuscitation bag during endotracheal suctioning.

OBJECTIVE: To examine nurses' ability to deliver 1.5 times the ventilated tidal volume at 100% FIO2 with a manual resuscitation bag during endotracheal suctioning. DESIGN: Prospective, descriptive. SETTING: Six adult critical care units in a large university-affiliated medical center. SUBJECTS: One hundred nurses randomly selected from the six adult intensive care units. OUTCOME MEASURES: Nurses' manual resuscitation bag delivery of tidal volume and oxygen, as well as bagging rate, number of breaths delivered, and number of suction catheter passes performed. Patients' heart rate, mean arterial pressure, and arterial oxygen saturation. RESULTS: The mean FIO2 delivered was 0.71 (range 0.24 to 0.97). Oxygen liter flow and nurses' delivered minute ventilation predicted 24% of the variance in FIO2 delivered. Mean bagging rate was 31 compressions per minute. The mean volume per breath delivered was 626 cc, which resulted in achievement of 57% of the standard (1128 cc). Volume achieved was related to patient lung compliance, but not related to nurses' experience, unit of employment, hand strength, or size. CONCLUSIONS: Nurses observed were unable to meet the standard for volume or oxygen delivery. However this did not affect the patient's heart rate, mean arterial pressure, or SaO2.

Adult↗
PubMedDate not supplied

Forecasting ambulatory clinic workload to facilitate budgeting.

Concern about controlling health care costs is a driving force in forecasting workload. The availability of computers and spreadsheet software now makes it possible for middle managers to forecast future workload using past workload data.

Ambulatory Care Facilities↗