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M Craft

Publications and source records attributed to M Craft.

At least 19 recordsLinked to original sources
PubMed1997

An outcomes analysis of in-hospital cardiopulmonary resuscitation: the futility rationale for do not resuscitate orders.

PURPOSE: Cardiopulmonary resuscitation (CPR) is a frequently performed medical intervention in hospitalized patients who die. Despite the widespread use of do-not-resuscitate (DNR) orders during the last decade, the outcome following CPR appears not to have improved. The key to an improved outcome may be better patient selection. The objective of this study was to determine the hospital survival rate following CPR in the era of DNR orders, and to identify risk factors predictive of hospital survival at a university-affiliated teaching hospital. MATERIALS AND METHODS: We retrospectively reviewed the code sheets and patient charts of all patients who underwent CPR during a 4-year period from January 1991 to January 1995. Three-hundred-and-eight patients were identified. RESULTS: CPR was successful in 99 (32%) patients, with 41 (13%) patients surviving to hospital discharge. All the patients who survived were otherwise "healthy" with reversible conditions, who experienced a sudden and unexpected arrhythmic event. No pre-arrest risk factors could clearly distinguish the hospital survivors from the nonsurvivors. The length of the code was 9.4 +/- 4 minutes in the hospital survivors compared with 26.6 +/- 19.1 minutes in the nonsurvivors. Patients whose initial rhythm was either ventricular tachycardia or fibrillation had a better survival rate than patients with other rhythms. CONCLUSION: DNR protocols do not prevent CPR being performed on patients who are unlikely to survive to hospital discharge. CPR should only be offered to patients who are likely to derive benefit from this intervention.

Adolescent↗
PubMed1995

Perceived changes in adult family members' roles and responsibilities during critical illness.

An exploratory design was used to study the effects of critical care hospitalization on family roles and responsibilities of adult family members and how these effects changed over time. A convenience sample of 52 subjects from pediatric, neonatal, surgical, medical, and cardiovascular intensive care units was used. Data were collected using an open-ended question contained in the Iowa ICU Family Scale (IIFS). Using qualitative techniques, seven themes were identified: (a) Pulling together, (b) Fragmentation of families, (c) Increased dependence, (d) Increased independence, (e) Increased responsibilities, (f) Change in routine, and (g) Change in feelings. These findings indicate that nurses need to implement family-centered interventions such as role supplementation programs or identification of support systems to decrease role strain and role overload in families during a crisis.

Adolescent↗
PubMed1994

Emotional responses of family members during a critical care hospitalization.

BACKGROUND: The needs and satisfaction levels of family members of critically ill patients have received much attention in the literature. The feelings of family members, however, have not been thoroughly investigated. To develop appropriate nursing interventions to assist family members in coping with a critical care hospitalization, accurate information about their emotional response to the situation is needed. OBJECTIVE: To examine emotional responses of family members and their descriptions of supportive behaviors of others during a critical care hospitalization. METHODS: An exploratory design was used to study 52 subjects with critically ill family members in the pediatric, neonatal, medical, surgical and cardiovascular intensive care units in a large tertiary care hospital. The subjects kept daily logs of their feelings and the supportive behaviors of others. Thematic analysis was used to identify major themes. RESULTS: Analysis revealed a broad range of powerful emotions throughout the intensive care unit stay. Negative and positive emotions such as despair and joy were sometimes identified by subjects within a 24-hour period. Although fear, worry, anger and exhaustion were dominant themes during the first 24 hours and when the family received bad news about the patient, there was no pattern of emotional response evident as the stay progressed. Some differences between subjects drawn from the medical and neonatal intensive care units were evident. CONCLUSIONS: The findings suggest that family members of critically ill patients experience deep emotional turmoil throughout the intensive care unit stay. Specific nursing interventions to promote adaptive coping are needed throughout the experience.

Adolescent↗
PubMed1993

Group functioning of a collaborative family research team.

Collaborative research teams are an attractive means of conducting nursing research in the clinical setting because of the many opportunities that collaboration can supply. These opportunities include a chance to: (1) network with other nurses who have similar interests, (2) share knowledge and expertise for designing clinical studies that directly affect daily practice, (3) develop instruments, (4) write grant proposals, (5) collect and analyze data, and (6) prepare manuscripts for publication. The effectiveness of research teams, however, is strongly influenced by group functioning. This article describes the functioning of a collaborative family interventions research team of nursing faculty members and CNSs at a large Midwestern university setting. The formation of the group and membership characteristics are described, along with strategies used to identify the research focus and individual and group goals. Aspects related to the influence of the group on members and the internal operations of the group are also addressed. Future strategies to be explored will focus on the size of the group and joint authorship issues. The authors also set forth a number of recommendations for development of collaborative research groups.

Clinical Nursing Research↗
PubMed1987

Lithium in the treatment of aggression in mentally handicapped patients. A double-blind trial.

In a double-blind trial lasting 4 months in 42 mentally handicapped patients, the effect of lithium on aggression was assessed in comparison with placebo. In the lithium-treated group, 73% of patients showed a reduction in aggression during treatment. There were significant differences in mean weekly aggression scores and in the frequency of aggressive episodes between the lithium and placebo groups. Side-effects were noted in 36% of the lithium group (and 20% of the placebo group), but were mainly transitory. There were no episodes of toxicity, and no patients had to be withdrawn from the trial. Lithium appears to be worth a 2-month trial in such patients, where repeated aggression has not been relieved by more appropriate placement, occupation or company.

Adult↗
PubMed1984

DHE in the classroom.

Explore the source record for details and available documents.

Health Education, Dental↗
PubMed1984

An investigation into the response of subjects to a plaque control programme as influenced by friends and relatives.

The aim of the present study was to assess the response of patients to a course of instruction in plaque control as influenced by friends and relatives. The subjects in the study were 41 patients who had been referred to a dental hospital for treatment. There was a major reduction in plaque and gingivitis levels in the subjects at both the 10th and 14th weeks of the study. There was a greater proportional reduction in gingivitis levels in those subjects who had a higher number of reported discussions with their friends. The effect of discussions with members of the family was less clear. Lower values for gingivitis levels at 10 weeks were associated with a higher number of discussions with parents. However the levels of gingivitis tended to be adversely affected by discussions between the subjects and their spouses. The importance of recognising the influence of family and friendship networks needs to be understood when preventive programmes are designed, especially where high levels of self-care are sought as outcomes. Further work is in progress on a group of office workers being treated in a dental practice environment. This will allow the type of advice being obtained from the various contacts to be investigated in more detail.

Adult↗
PubMed1984

Natural Nashers: a programme of dental health education for adolescents in schools.

This research set out to recognize and overcome the difficulties and doubts in designing, testing and disseminating a dental health education programme for adolescents, as part of their school curriculum. After extensive pilot work, large-scale field trials were mounted of Natural Nashers for 13-14-year-old pupils in school. These trials ran among 6700 pupils in 45 largely urban, mixed sex, state comprehensive schools in England and Scotland. A quasi-experimental control group design was used and evaluation was carried out at the levels of process (teachers' questionnaires, pupils worksheets, field-workers' reports) and outcome (pupils' pre- and post-questionnaires, worksheets, plaque and gingival scores), among a random subsample (n = 1900) divided between study (n = 1300) and control (n = 600). Eighty-three teachers completed a questionnaire and 330 field workers' reports were analysed. Two hundred and fifty pupils were further examined after a minimum of 6 months. Significant improvements in plaque and gingival scores, knowledge and attitudes compared to control pupils were noted. Gains in the areas of knowledge and attitudes were the largest of any recorded in similar trials in Europe. Process data showed that in the experimental schools, improved oral hygiene was correlated with teachers who were enthusiastic and used a cooperative style. Results from the teachers' questionnaire showed that the programme was very well received and educationally suitable.

Adolescent↗