Biomedical subjects

M J Bernier

Publications and source records attributed to M J Bernier.

7 recordsLinked to original sources

PubMed2001

Hysteroscopic endomyometrial resection of three uterine sarcomas.

STUDY OBJECTIVE: To describe our experience with three uterine sarcomas associated with hysteroscopic endometrial ablation. DESIGN: Cohort study (Canadian Task Force classification II-2). SETTING: University-affiliated teaching hospitals. PATIENTS: Three of 2402 women undergoing hysteroscopic endometrial ablation who had uterine sarcomas. INTERVENTION: Hysteroscopic endomyometrial resection. MEASUREMENTS AND MAIN RESULTS: One low-grade endometrial stromal sarcoma and two carcinosarcomas were resected. After hysterectomy in two patients, no residual cancer was identified in one of them. The third patient was an 82-year-old woman with moderate menorrhagia who refused hysterectomy. After endomyometrial resection she remained amenorrheic for the last 14 months of her life. CONCLUSION: From our experience the incidence of uterine sarcomas is approximately 1/800 women undergoing hysteroscopic ablation for abnormal uterine bleeding. Complete endomyometrial resection is feasible and may be offered as diagnostic and palliative therapy in women at high risk for hysterectomy.

Aged↗

PubMed2001

Pulmonary rehabilitation after acute COPD exacerbation.

Acute COPD exacerbation provides a window of opportunity for providing teaching, supportive care, and rehabilitation to a group of patients at high risk for complications and re-admissions. This article has attempted to make a case for the unique needs of this group of patients. Treatment of exacerbation is often viewed as "routine" by hospital staff and generally has focused upon the pharmacologic regimen of oxygen therapy, bronchodilators, antibiotics, and steroids. Within a few days, the patient is usually less dyspneic and is discharged with a combination of MDIs and a plan for steroid taper. All too often, the patient returns home with no idea of how to regain lost function or prevent future exacerbations. The use of the MAC provides a more complete picture of the unique needs and capabilities of COPD patients and brings together the collective expertise of the entire health team in designing a plan of rehabilitative care. Planned monitoring of the patient after discharge is an integral component to the success of the rehabilitation approach and the ability of the patient and family to move toward self-management of this chronic disease. Transitional care programs, community nurse referrals, telephone contacts, and outpatient visits are all appropriate methods for providing the type of support required to sustain rehabilitation. Traditionally, nurse researchers have examined psychosocial and functional performance outcomes of rehabilitation, however, nurses are in an ideal position to explore the methods of rehabilitation that yield the most positive outcomes over time and are sustainable over the course of the disease. Nursing can and should assume a leadership role in such initiatives.

Exercise Therapy↗

PubMed1998

Health-related quality of life in chronic disorders: a comparison across studies using the MOS SF-36.

The purpose of this report is to examine health-related quality of life (HRQoL) as measured by the Medical Outcomes Study Short Form-36, across patient populations with chronic disorders and to compare quality of life (QoL) in these subjects with normative data on healthy persons. Six studies, within the Center for Research in Chronic Disorders at the University of Pittsburgh School of Nursing, in patients with urinary incontinence, prostate cancer, chronic obstructive pulmonary disease (COPD), acquired immune deficiency syndrome (AIDS), fibromyalgia and hyperlipidaemia provided the data for analysis. The results demonstrated that not only did the prostate cancer and hyperlipidaemia patients have the highest QoL across the chronic disorders, but their QoL was comparable to normative data on healthy persons. Homebound, elderly, incontinent patients had the lowest QoL for physical functioning, whereas patients hospitalized with AIDS had the lowest QoL in general health and social functioning. Patients with COPD had the lowest QoL in role-physical, role-emotional and mental health. Patients with fibromyalgia had the lowest QoL in bodily pain and vitality. Compared to normative data, patients with urinary incontinence, COPD, AIDS and fibromyalgia generally had lower QoL. Prostate cancer and hyperlipidaemia patients had QoL comparable to normative data. Compared to normative data, patients with urinary incontinence, COPD, AIDS and fibromyalgia had more variability for role-emotional. AIDS patients had more variability on physical functioning, bodily pain and social functioning compared to the normative data. These data suggest that patients with various chronic disorders may have QoL that is lower in most domains compared to a healthy population. However, there may be differences in the domains affected as well as the extent of variation across specific chronic disorders.

Aged↗

PubMed1996

Establishing the psychometric properties of a scale for evaluating quality in printed education materials.

A study establishing the psychometric properties of a quality standard for quantifying the presence (or absence) of instructional design/learning principles contained in printed education materials (PEMs) was conducted in 4 phases. Content validity, a pretest which included creation of a rating key, inter-rater reliability, and intra-rater reliability levels were established for the Bernier Instructional Design Scale (BIDS). Experts in patient education established content validity by identifying 37 instructional design/learning principles as essential to PEM quality from a 90 item domain. An inter-disciplinary group of 89 health professionals applied the BIDS to a test PEM. Group ratings were compared with a rating key which served as a validated standard for the presence of principles in the test PEM. Reliability of the BIDS achieved acceptable levels when rating categories were collapsed from 4 to 3 levels to be consistent with a measurement model for rating checklists. A revised methodological approach and program of psychometric research are described.

Humans↗

PubMedDate not supplied

Lessons from an evaluation of the effectiveness of an asthma day camp.

PURPOSE: To evaluate the effectiveness of applied teaching methodologies in a camp setting on asthma self-management skills in school-age children. DESIGN: This was a descriptive pilot study using a one-group pretest-posttest design. SAMPLE: Thirty-four subjects, ages 6 to 12 years, representing a typical clinical population of children with asthma. METHODS: Children's asthma knowledge, symptoms, behavior, and mastery, as well as peak-flow technique, were measured 2 to 3 weeks before camp and then again on the last day of camp. Baseline measures of parents' asthma knowledge and family stress related to asthma were obtained. Outcomes specific to asthma management, such as missed school days, emergency room visits, and hospitalizations, were evaluated by parent report the year before and after the intervention. RESULTS: Significant improvement in peak-flow technique and a reported reduction in emergency room visits and missed school days after camp were found. CLINICAL IMPLICATIONS: In this pilot study, the use of an applied teaching format for school-age children in an asthma day camp resulted in some learning. More rigorous design and instrumentation are important for better evaluation of programs such as this. Nurses working with these populations should plan structured evaluations of the programs so they can best meet the children's needs.

Asthma↗

PubMedDate not supplied

Developing and evaluating printed education materials: a prescriptive model for quality.

Nurses are frequently called upon to develop and evaluate printed education materials (PEMs) in their role as patient educators. This article describes the use of the Evaluating Printed Education Materials (EPEM) model as a prescriptive guide and quality standard for developing new PEMs or critiquing existing ones. Outlined in the five phases of the model are a series of nursing, learning, and instructional design principles that are intended to increase the relevance, readability, and comprehensibility of PEMs for the patients and families who use them. The patient-centered focus of the model makes it applicable across nursing specialty areas and care settings. Examples of how the model can be used in the care of orthopaedic patients are presented.

Humans↗

PubMedDate not supplied

Relationship of cardiac inpatients' outcomes to mood state.

This descriptive study used a computerized charge capture system (CCCS) to explore the differences of cost and length of stay (LOS) between cardiac inpatients with a diagnosis of depression (n = 144) and cardiac inpatients without depression (n = 9,099). Level of severity, gender, and mood state (depression vs. nondepression) were also compared. A matched sample of 352 nondepressed patients was compared with a sample of 94 depressed patients. There were no significant differences between the depressed and nondepressed groups. However, the study did indicate interesting findings regarding mood state, gender, and cardiac outcomes. Depression was significantly overrepresented among females (chi 2 = 24.0, df = 1, P < 0.05). When gender and mood state were considered together, women with cardiac disease who were depressed had significantly longer lengths of stay (LOSs) and increased costs than men with depression (F = 6.6, df = 1, P = 0.01). A major unanticipated finding was the extremely low incidence of depression detected in these patients (1.6%) when compared with patients in other studies. One possible reason for the low incidence of depression was related to the use of a financial, rather than a clinical, data set.

Adult↗