Words on standardized languages.
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Humans↗
Biomedical subjects
M Maas
Publications and source records attributed to M Maas.
Genetic counseling outcomes validation by genetics nurses in the UK and US.
PURPOSE: To validate genetic counseling outcomes with a sample of genetics nurses from the United Kingdom (UK), and to compare elements of genetic counseling outcomes with those from a sample of genetics nurses from the United States (US). DESIGN: Descriptive-comparative survey. METHODS: Concept analysis and literature review were used to designate outcomes, and genetics nurses were surveyed to validate the outcomes. A revision of Fehring's 1987 methodology for assessing content validity was used to estimate content validity and sensitivity of the genetic counseling outcomes. Data are reported on a convenience sample of 50 UK nurse members of the Association of Genetic Nurses and Counsellors. Findings were correlated with prior data from a convenience sample of 92 U.S. nurse members of the International Society of Nurses in Genetics, Inc., and data were compared between groups. FINDINGS: A significant positive correlation was found between samples of U.K. and U.S. nurses regarding components of outcomes of the genetic counseling process and between groups regarding extent of contribution of nurses to the outcomes. Strength of nursing contributions to knowledge of disease and indicators of coping varied according to country. CONCLUSIONS: Genetics nurses in the UK and US had similar definitions of outcomes of genetic counseling, but priorities of indicators differed between countries. Terminology used in measures to identify outcomes of the process of genetic counseling must be consistent with cultural norms.
Genetic Counseling↗
Ulnar variance and the shape of the lunate bone. A radiological investigation.
The authors designed a study to test the hypothesis that the length of the ulna might affect the shape of the lunate bone because of long-term molding during life. This might then be useful to predict the presence or absence of a dynamic or static ulna plus by the shape of the lunate bone. In a prospective study, posterior-anterior wrist x-rays were taken in a standard fashion in 68 patients with a mean age of 34.5 years. Dominance, grip strength, ulnar variance and the shape of the lunate were recorded. Lunate shape, type 1, which is the least molded, was seen most frequently on both the left and right side and did not correlate with the dominant side. The most molded, type 3, was seen less frequently and almost exclusively on the nondominant side. No correlation was found between dynamic ulna plus and the type 3 lunate. Following statistical analysis, no correlation between ulnar variance and lunate shape was found, indicating that the shape of the lunate bone had no predictive value for predicting the presence or absence of a dynamic ulna plus variance. The hypothesis that the length of the ulna might influence the ultimate shape of the lunate could not be demonstrated.
Adolescent↗
MRI in clinically asymptomatic neuropathic leprosy feet: a baseline study.
This study was undertaken to analyze the magnetic resonance imaging (MRI) findings in the clinically asymptomatic neuropathic feet of leprosy patients. Since in the literature no MRI data are available concerning the asymptomatic neuropathic foot in leprosy, the interpretation of MRI examinations in clinically suspected neuropathic feet in leprosy is difficult. We examined 10 adult leprosy patients with clinically asymptomatic neuropathic feet. Inclusion criteria were a normal or near normal neuropathic foot, without signs of inflammation. All patients underwent an MRI protocol with the inclusion of two-point Dixon chemical shift imaging as fat suppression sequence. We found MRI changes in almost all patients. The most striking were the changes located in the region of the first metacarpophalangeal (MTP) joint. These changes ranged from degradation and interruption of the subcutaneous fat to effusion/synovitis in the first MTP joint. This study reveals significant MRI changes in clinically asymptomatic neuropathic feet in patients with leprosy. These changes may relate to the development of ulcerations. MRI may play an important role in detecting feet at risk and may influence clinical decision making.
Adult↗
Upper thoracic spinal fractures in trauma patients - a diagnostic pitfall.
The diagnosis of upper thoracic spinal fractures in multiple-trauma patients remains a challenge. The clinical findings are often difficult to detect, especially in the presence of other (extremity) fractures, head injuries or in patients on respiratory support. The findings of chest radiographs and plain spinal films are described in a series of 23 patients with an upper thoracic spinal fracture. Radiographs were retrospectively reviewed by an orthopaedic surgeon and a skeletal radiologist. Fractures were classified according to Magerl and type A1 and A2 compression fractures were excluded. The neurological outcome was assessed using the Frankel scale.Initially, the fracture was missed in 5 patients (22%), mainly due to concomitant life-threatening injuries. Fractures consisted of type A, B and C in one, 10 and 12 patients, respectively. The main findings were: loss of vertical height of vertebra with or without malalignment (21), widened paraspinal line (21), widened mediastinum (4) and no gross abnormalities (2). Neurological lesions were Frankel A, B, C and E in respectively 14, 1, 1 and 7 patients.Upper thoracic spinal fractures are easily missed in patients with multiple injuries. In patients with neurological symptoms CT and/or MRI is required as soon as the general condition of the patient permits this.
Adolescent↗
Initial field testing of an instrument to measure: observable indicators of nursing home care quality.
The "Observable Indicators of Nursing Home Care Quality" instrument was developed as a new measure of nursing home care quality. The instrument is based on a theoretical model of quality nursing home care grounded in data from provider and consumer focus groups. The instrument was piloted in 10 Missouri nursing homes. Subsequent versions were tested in 109 Missouri and 11 Icelandic nursing homes. Content validity was established using experts. Concurrent and known groups validity was evaluated using Minimum Data Set quality indicators, survey citations, and a process of care measure. Interrater and test-retest reliabilities were calculated as well as coefficient alpha. The "Observable Indicators of Nursing Home Care Quality" instrument is a new measure that can be used by researchers, and potentially by regulators, consumers, or providers, to observe and score specific indicators of quality care following a 20- to 30-minute inspection of a nursing home.
Focus Groups↗
Evaluating nursing administration instruments.
OBJECTIVE: To identify and evaluate available measures that can be used to examine the effects of management innovations in five important areas: autonomy, conflict, job satisfaction, leadership, and organizational climate. BACKGROUND: Management interventions target the context in which care is delivered and through which evidence for practice diffuses. These innovations need to be evaluated for their effects on desired outcomes. However, busy nurses may not have the time to locate, evaluate, and select instruments to measure expected nursing administration outcomes without research-based guidance. Multiple and complex important contextual variables need psychometrically sound and easy-to-use measurement instruments identified for use in both practice and research. METHOD: An expert focus group consensus methodology was used in this evaluation research to review available instruments in the five areas and evaluate which of these instruments are psychometrically sound and easy to use in the practice setting. RESULTS: The result is a portfolio of measures, clustered by concept and displayed on a spreadsheet. Retrieval information is provided. The portfolio includes the expert consensus judgment as well as useful descriptive information. CONCLUSIONS: The research reported here identifies psychometrically sound and easy-to-use instruments for measuring five key variables to be included in a portfolio. The results of this study can be used as a beginning for saving time in instrument selection and as an aid for determining the best instrument for measuring outcomes from a clinical or management intervention.
Conflict, Psychological↗
Outcome indicators for direct and indirect caregiving.
Informal caregiving and outcomes for caregiving are an important part of health care and of particular importance in nursing. The purpose of this research is to report the results of a survey mailed to nursing experts for validation of the outcome labels Caregiver Role Performance: Direct Care and Caregiver Role Performance: Indirect Care and their accompanying indicators. Experts were asked to rate how important the identified indicators were for assessing those two outcomes. In addition, the respondents were asked to what extent nursing interventions influence the achievement of each identified indicator for Caregiver Role Performance: Direct Care and Caregiver Role Performance: Indirect Care. In general, the validity of the concept analysis work by the caregiver focus group was supported. Ten indicators for Caregiver Performance: Direct Care were retained, 1 was dropped that was considered most appropriate for indirect care, and 3 new indicators were added to reflect the nurse experts surveyed. For Caregiver Performance: Indirect Care, all of the indicators were retained.
Caregivers↗
Acute confusion indicators: risk factors and prevalence using MDS data.
Long-term care (LTC) Minimum Data Set (MDS) data from a Midwestern state were analyzed to validate whether components of a conceptual model developed from findings in acute care identified acute confusion risk variables in LTC. The prevalence of probable acute confusion in this sample was 13.98% (n = 324). Using a cross-sectional design, both univariate and unconditional stepwise logistic regression analyses were accomplished with presence or absence of probable acute confusion as the outcome variable (N = 2,318). Variables significantly related to acute confusion by univariate analysis were included in the logistic regression analysis. Inadequate fluid intake was the first variable to enter the stepwise equation and was highly significant (OR 3.40, 95% CI 2.99-3.81, p < .0001). Other significant variables included a diagnosis of dementia or a fall in the last 30 days. Implications for nursing practice, education and research are discussed.
Acute Disease↗
MRI-induced retrocalcaneal bursitis.
This case report describes a patient with acute retrocalcaneal bursitis, which developed after MRI examination of the ankle. The sagittal T2*-weighted gradient echo sequence revealed an extensive susceptibility artifact in the area surrounding the Achilles tendon near its insertion at the os calcis. This artifact was caused by postsurgical metallic particles. We postulate that these particles were mechanically stimulated by the magnetic field and induced the inflammatory response.
Achilles Tendon↗
Diagnosis and treatment of scaphoid fractures, can non-union be prevented?
In order to evaluate the diagnostic management of scaphoid fracture, 100 consecutive patients with clinically suspected scaphoid fractures were investigated. If a scaphoid fracture was seen on scaphoid radiographs, patients were immobilized in a plaster cast. If the radiographs were negative or dubious for scaphoid fracture, patients were referred for three phase bone scintigraphy. Then the patient was treated according to the result of the bone scan. A long-term follow-up (minimum 1 year) was performed in order to evaluate the incidence of non-union. In 49 of the 100 patients, a fracture of the scaphoid was recognized, in 29 of whom their scaphoid X-series was positive for scaphoid fracture. In 3 of the remaining 71 patients with negative scaphoid X-series, additional carpal box radiographs showed a scaphoid fracture, while 68 patients were referred for three-phase bone scintigraphy. Of these 68 patients, 17 patients (25%) showed a hotspot on the bone scan in the region of the scaphoid. We found that scaphoid radiographs, additional carpal box radiographs and the bone scan (in radiographically negative patients) in combination with conservative therapy did not lead to non-union at long-term follow-up in patients who were treated for scaphoid fracture. We conclude that when a scaphoid fracture is diagnosed within the 1st week followed by plaster immobilization, non-union of the scaphoid could be prevented.
Adolescent↗
Nursing home care quality: a multidimensional theoretical model integrating the views of consumers and providers.
This exploratory study was undertaken to discover the defining dimensions of nursing home care quality from the viewpoint of consumers of nursing home care. Eleven focus groups were conducted in five Missouri communities. The seven dimensions of the consumer multidimensional model of nursing home care quality are: staff, care, family involvement, communication, environment, home, and cost. The views of consumers and families are compared with the results of a previous study of providers of nursing home services. An integrated, multidimensional theoretical model is presented for testing and evaluation. An instrument based on the model is being tested to observe and score the dimensions of nursing home care quality.
Attitude of Health Personnel↗
Uniform fat suppression in hands and feet through the use of two-point Dixon chemical shift MR imaging.
PURPOSE: To assess the potential of two-point Dixon chemical shift magnetic resonance imaging to achieve uniform fat suppression in the distal parts of the extremities. MATERIALS AND METHODS: Two-point Dixon chemical shift imaging was performed in 31 consecutive patients clinically suspected to have bone marrow disease. In some patients, Dixon studies were performed before and after the intravenous administration of gadopentetate dimeglumine, and in some patients follow-up examinations were performed, for a total of 64 studies. Areas of interest were the hand, wrist, foot, ankle, and lower leg. There was a special interest in the neuropathic foot and osteomyelitis. The uniformity of fat suppression in the entire field of view, the frequency of displacement artifacts, and the applicability of the technique in routine patient treatment were evaluated. RESULTS: In 64 (100%) Dixon studies, uniform fat suppression was achieved. In 59 (92%) studies, there were no displacement artifacts. In five (8%) studies, displacement artifacts occurred; however, in only one (2%) study did they severely hamper the reading. Thus, in 63 (98%) studies, adequate diagnostic quality was obtained. CONCLUSION: Two-point Dixon chemical shift imaging is a good technique for achieving uniform fat suppression in the distal parts of the extremities. Because the frequency of displacement artifacts is low, the technique is applicable in a routine clinical setting.
Adipose Tissue↗
Nursing home care quality: a multidimensional theoretical model.
This exploratory study was undertaken to discover the defining dimensions of nursing home care quality and to propose a conceptual model to guide nursing home quality research and the development of instruments to measure nursing home care quality. Three focus groups were conducted in three central Missouri communities. A naturalistic inductive analysis of the transcribed content was completed. Two core variables (interaction and odor) and several related concepts emerged from the data. Using the core variables, related concepts, and detailed descriptions from participants, three models of nursing home care quality emerged from the analysis: (1) a model of a nursing home with good quality care; (2) a model of a nursing home with poor quality care; and (3) a multidimensional model of nursing home care quality. The seven dimensions of the multidimensional model of nursing home care quality are: central focus, interaction, milieu, environment, individualized care, staff, and safety. To pursue quality, the many dimensions must be of primary concern to nursing homes. We are testing an instrument based on the model to observe and score the dimensions of nursing home care quality.
Attitude to Health↗
The Nursing Outcomes Classification.
The Nursing Outcomes Classification (NOC) is a comprehensive taxonomy of patient outcomes influenced by nursing care. Each outcome is stated as a variable concept measured on a five-point Likert scale and includes a definition, indicators, and references. The classification provides outcomes that can be used across the care continuum to assess patient status following nursing interventions. The classification has a number of advantages, including being research-based, standardized, comprehensive, and flexible for clinical use. It was developed by a large research team that included clinical experts and has been subjected to testing.
Humans↗
The nursing outcomes taxonomy: development and coding.
Interest in the theoretical knowledgebase of nursing has increased over the last 25 years and has led to the current interest in middle-range theory development to describe the essence of nursing. This article describes the creation of a three-level taxonomy and coding structure for the Nursing Outcomes Classification (NOC) based on methods developed by the Nursing Interventions Classification (NIC) work. A model is presented depicting the importance of standardized nursing diagnoses, interventions, and outcomes in the development of the substantive component of nursing practice and to enable nurses to be accountable for care of their clients.
Abstracting and Indexing↗
Alzheimer's disease genetics. Practice and education implications for special care unit nurses.
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Aged↗
Verifying nursing home care quality using minimum data set quality indicators and other quality measures.
Researchers, providers and government agencies have devoted time and resources to the development of a set of Quality Indicators derived from Minimum Data Set (MDS) data. Little effort has been directed toward verifying that Quality Indicators derived from MDS data accurately measure nursing home quality. Researchers at the University of Missouri-Columbia have independently verified the accuracy of QI derived from MDS data using four different methods; 1) structured participative observation, 2) QI Observation Scoring Instrument, 3) Independent Observable Indicators of Quality Instrument, and 4) survey citations. Our team was able to determine that QIs derived from MDS data did differentiate nursing homes of good quality from those of poorer quality.
Data Collection↗