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Biomedical subjects

M L Lanza

Publications and source records attributed to M L Lanza.

At least 19 recordsLinked to original sources
PubMed1997

Quality plan for a product line.

Continuous Quality improvement (CQI) has undergone radical change as health care facilities merge, expand, and modify their existing services. CQI has shifted from a centralized position in health care organizations, to unit based, to product lines. This paper describes one product line's endeavors to develop a Quality Plan to direct CQI activities. One particular strength of our innovation is that the Quality Plan was developed with attention to the important balance of interdisciplinary cooperation and maintenance of appropriate discipline boundaries.

Hospitals, Veterans↗
PubMed1997

Validation of a vignette simulation of assault on nurses by patients.

PURPOSE: To determine the degree to which causal attribution ("blame") scores obtained from written vignettes of assault incidents, simulations of reality, reflect results that would be obtained from victims of actual assaults. DESIGN: Correlational study. Data were collected, 1990-1993, from a convenience sample of 59 RNs who had been assaulted verbally or physically at one neuropsychiatric hospital in the United States. METHODS: Victims used the Causal Attribution Scale to assign blame for their assault. Three judges then used the same scale to attribute cause for the assault based on a written description of the assault by the victim. FINDINGS: No significant differences in mean causal attribution levels were found between victims and the average ratings for the three judges for mild or severe assaults, nor between victims, judges, and the response levels obtained in two previous vignette studies. CONCLUSIONS: Mean causal attribution ("blame") scores observed in simulations that are carefully constructed assault vignettes are nearly the same as those observed in actual assaults. Vignettes appear promising as a simulation to study actual or hypothetical responses to assault.

Adult↗
PubMed1996

Money: personal issues affect professional practice.

Money is a taboo subject. Clinicians have much ambivalence about money, both personally and professionally, and are often more comfortable discussing clients' issues around money than examining their own. As a result, how clinicians handle money with clients is often determined by the clinicians' personal feelings about money; however, they do not explore the meaning and origin of these feelings or determine how these feelings affect their practices. This article explores the conscious and unconscious issues surrounding money, case examples of therapists' dilemmas in handling money, and implications for practice.

Attitude of Health Personnel↗
PubMed1996

The relationship of behavioral cues to assaultive behavior.

The purpose of this 2-year, case control study was to determine whether differentiation between assaultive and nonassaultive patients can be made based on behavioral assessments and/or sociodemographic variables. For each assault incident, the chart of the patient who assaulted and a randomly chosen patient who did not assault on that day were reviewed (N = 72 subjects or 26 pairs). Various scales were used to evaluate the subjects retrospectively (the day prior to the assault), and patients who assaulted staff were interviewed when possible. An analysis found no differences between patients who assaulted and controls on sociodemographic variables. Those who assaulted had significantly more prior assaults (p = .04) and more difficulty verbalizing angry feelings appropriately on their units (p < .01). Prior to the assault, assaultive patients were more verbally hostile (p = .037) and showed more increased motor activity (p = .001) than controls.

Cues↗
PubMed1995

The "ups" and "downs" of getting published.

One stumbling block to writing is the variety of emotional reactions a prospective author must negotiate: the "ups" and "downs" of publishing. An impressive publishing track record does not necessarily mean an author will avoid anxiety, self-doubt or the fear of rejection. A conceptual schema outlines the phases in the publishing process and the associated potentially problematic emotional reactions.

Adaptation, Psychological↗
PubMed1993

The parallel process of resistance by clients and therapists to starting groups: a guide for nurses.

Group psychotherapy is well recognized as a treatment modality with a powerful healing capacity. Yet, as experienced group therapists will attest, it is immensely difficult to begin a group. Assembling clients who have sufficiently dealt with their resistance to join a psychotherapy group is a painstaking process. Students in group psychotherapy training programs also find beginning a new group an arduous and frustrating task. The authors have had the benefit of postgraduate group psychotherapy training program to build on the expertise and skills already familiar to the Clinical Nurse Specialist. Our understanding of the parallel process in the resistance to beginning a group grew out of our training experience. We will explore within the parallel process framework some of the factors that make the development of a group psychotherapy practice as complex. Parallels will be drawn between clinician resistance to beginning a new group and client resistance to joining a group.

Defense Mechanisms↗
PubMed1992

Nurses as patient assault victims: an update, synthesis, and recommendations.

The literature documenting the incidence and reactions of nursing staff who have been assaulted by patients is increasing. Before 1980 very little work was done in the area. What did appear generally indicated that patient violence against staff was infrequent, and on the rare occasion when it did occur the staff member was usually in some way responsible. Current research shows that assault is a serious risk factor for nurses. The incidence of assault is high and vastly underreported. Staff members experience short- and long-term emotional, social, biophysiological, and cognitive reactions to being assaulted. Interventions to help the staff victim in the recovery process are increasingly used.

Adaptation, Psychological↗
PubMed1991

Literature: a vehicle for emotional connection between clinician and client.

Nurses have used literature in a variety of ways to increase understanding of the problems and dilemmas of their patients. Literature can be used in psychotherapy when a patient either selects a literary work to discuss or writes his or her own work. Incorporation of literature into psychotherapy offers opportunities for discussion that yield important information about the patient as he or she explores conscious and unconscious issues.

Bibliotherapy↗
PubMed1991

Blaming the victim: complex (nonlinear) patterns of causal attribution by nurses in response to vignettes of a patient assaulting a nurse.

When 60 staff nurses at a Veterans Administration hospital were asked to respond to vignettes in which a nurse is subjected to varying degrees of assault, blaming the nurse was at its highest level in response to the mild assault vignette, rather than to the extreme conditions (no physical contact or severe physical assault). When asked directly who was to blame for the assault in the vignette, not one nurse cited the patient.

Adult↗
PubMed1990

The use of control vignettes.

A review of the literature revealed control, or placebo, vignettes are not used in numerous studies that employ vignette-based methodology. This is a serious flaw. The nature of this flaw and its methodological and theoretical importance are outlined in this paper as are procedures and a model for developing control vignettes.

Aggression↗