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Biomedical subjects

M Grant

Publications and source records attributed to M Grant.

At least 271 records · Page 15Linked to original sources
PubMed1966

VD in D.C.

Explore the source record for details and available documents.

District of Columbia↗
PubMedDate not supplied

Analysis of content regarding death and bereavement in nursing texts.

Information contained in textbooks provides the foundation for undergraduate education and entry into clinical practice. Inadequate knowledge of health care professionals in end of life (EOL) has been documented and efforts are in progress to improve this care. This paper reports on a project to strengthen nursing education in EOL care. One of the three project goals was the evaluation of EOL content in 50 nursing textbooks. This paper reports findings in two of the nine areas of the analysis framework which are Death and Bereavement. Findings indicate significant deficiencies in the content within these texts. Improvement in text content will require collaboration of palliative care professionals and textbook publishers and can result in increased ability of nurses to improve EOL care.

Attitude to Death↗
PubMedDate not supplied

Strengthening nursing education to improve end-of-life care.

The survey results provide future direction for nursing education. Results indicate an awareness in the nursing profession of the need for improved EOL care and identification of resources to achieve that goal. Many activities have been initiated within the nursing community, and the results of this project hopefully will stimulate additional activities. The imperative for improved EOL care will escalate in the future as our elderly population grows and a burdened health care system confronts the costs of chronic and terminal illness. Palliative care, which has traditionally been limited to hospice programs, must extend to other settings and be incorporated into the trajectory of care. The IOM report and other palliative care literature asserts that improved care for the dying will necessitate change at many levels. Patients and the general public must be educated to expect a higher standard of care at the EOL. Health care system changes are needed to improve access to care and to eliminate barriers such as regulatory constraints on prescribing opioids. However, central to all health care reform is the need for educated professionals to direct this change. As professionals dedicated to patient comfort and quality of life--even at the EOL, nurses should begin the revolution in EOL care by attending to the education of nurses.

Clinical Competence↗
PubMedDate not supplied

HOPE. Home Care Outreach for Palliative Care Education.

PURPOSE: The goal of this project was to develop and test an educational program to extend the principles of palliative care into home-care agencies. The specific aims were: 1) to assess current practices within select home-care agencies regarding care of the dying; 2) to design the educational program, the HOPE (Home Care Outreach for Palliative Care Education) curriculum, to include relevant content for realistic implementation in home-care agencies; 3) to implement the HOPE project in two home-care agencies; and 4) to assess outcomes of the project and plan for future dissemination to home-care agencies and organizations. DESCRIPTION OF PROGRAM: A pilot project developed and tested five training modules including overview of end-of-life care, pain management, symptom management, communicating with patients and families, and the death event. A needs assessment survey completed by 134 home-care agencies provided input for the training course development. The five-part curriculum was developed by an interdisciplinary team of investigators and consultants and implemented in two agencies with 52 staff members participating. Two agencies then were selected to participate in pilot testing the curriculum. Precourse and postcourse surveys provided evaluation of the program content. RESULTS: Results from the home-care agency survey demonstrated the need for improving end-of-life care. Only 32% of nonhospice agencies reporting the availability of specially trained nurses for care of the terminally ill, and only 16% of the agencies reported providing such training. Pilot testing of the HOPE curriculum suggested that it was well received by staff members. Assessment of both self-effectiveness and agency effectiveness revealed greater comfort with content such as communication and other symptom management followed by the areas of pain management, managing the death at home, and cultural issues in end-of-life care. The overall rating of end-of-life care increased from a mean rating of 5.97 to 7.42 for self-assessment and from 6.59 to 7.94 for agency assessment (on a scale of 0 to 10, with 0 = not at all effective to 10 = very effective). This project identified areas of education needed to improve care at the end of life. The HOPE curriculum will be refined and extended to reach other home-care agencies to benefit their staffs and the patients they serve. CLINICAL IMPLICATIONS: Home care agencies provide extensive care to patients and families facing many physical and psychosocial demands at the end of life. Palliative care education is important to support home-care professionals across all disciplines in optimum end-of-life care. This education should focus on aspects of physical care, such as treatment of pain, dyspnea, confusion, and fatigue, and also to address decisions about physical care, such as hydration/nutrition at the end of life. Psychosocial dimensions of care at home can be improved by attention to issues such as communication with dying patients and families, cultural considerations, and the special care required at the time of the actual death at home.

Community Health Nursing↗
PubMedDate not supplied

Developing a community program on cancer pain and fatigue.

PURPOSE: The overall purpose of this project was to establish a community-based educational model on pain and fatigue management for individuals with cancer. The specific aims were: 1) to develop an appropriate educational program; 2) to pilot test this program in a community setting that supported a self-care approach; and 3) to evaluate the program process and outcomes. DESCRIPTION OF PROGRAM: The I Feel Better program was implemented through a two-session educational workshop taught by masters-prepared oncology nurses and was held at four Southern California sites of The Wellness Community. The focus of the sessions was to provide participants with general information about each symptom, assessment and management of those symptoms, and strategies for effectively communicating with their healthcare providers. Sessions of 2.5-hour duration were held on Saturday mornings and required preregistration. RESULTS: The participants were primarily female and White, with an average age of 58 years. Participants reported considerable pain and fatigue. They also lacked accurate information about pain management. Program evaluation revealed that the content and format were well received by the participants. They rated the program as extremely useful and reported positive outcomes after the first session. CLINICAL IMPLICATIONS: This pilot educational intervention program has strong implications for multidisciplinary educational approaches for patients with cancer. Limitations resulted from the setting selected and the possibility that participants were already active in their fight against cancer. Generalization to other community settings may not be as successful. Programs could be cosponsored by several collaborating institutions to share resources. Referral to community programs by physicians, nurses, and social workers can occur as needed when identified during patient interventions. The voluntary participation of health professionals in community education programs could provide a valuable service for patients and a rewarding experience for educators.

Adult↗
PubMedDate not supplied

Subjective distresses of nasogastric tube feeding.

Health care professionals assume that tube feeding is an unpleasant, distressing experience for patients, which is only partially substantiated by experience. Thirty patients were interviewed via a tube feeding and hospital experience checklist (a 47-item interview schedule). Common experiences were operationally defined as those felt by at least 50%; subjectively distressful experiences were those identified by patients as causing distress. The most common and most distressful experiences of nasogastric tube feeding were: sensory irritations and sensory deprivation. The psychosensory irritation experiences were: thirst, sore nose or throat, dry mouth, runny nose, a tube in the nose, taking food through a tube, breathing through the mouth, breathing with a tube in the nose, taking food in a treatment type container, and taking food with a different texture and smell than usual. The psychosensory deprivation experiences were: an unsatisfied appetite for certain foods, deprivation of tasting, chewing, swallowing food, and drinking liquids, limited mobility, and deprivation of regular food. Except for burping, gastrointestinal symptoms were not common though they were usually distressful. This information has been used to develop teaching programs which are being tested for effectiveness in reducing distress associated with nasogastric tube feeding.

Adult↗
PubMedDate not supplied

Research priorities for drug and alcohol studies: the next 25 years.

This paper identifies likely important research directions in drug and alcohol studies during the next quarter century. The discussion focuses first on several emergent trends in contemporary research which have the potential to make crucial contributions both to our general understanding of psychoactive substance use and associated disorders, and to the promotion of international public health. Implications of these developments for future research agendas are discussed, including the study of drugs, alcohol, and AIDS; prevention strategies; problem rates; and the study of traditional and modern uses of psychoactive substances.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Rhythm and conduction disorders in formulating a judgment of work fitness].

Assessment of work fitness must take due account of clinical and/or laboratory findings, which may at times not be clear, when these are indicative of heart "disease". It is, however, necessary to discriminate between invalidating conditions which in certain jobs may lead to adverse effects, morphological alterations, and/or "benign" rhythm anomalies.

Arrhythmias, Cardiac↗