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Biomedical subjects

M Nield

Publications and source records attributed to M Nield.

13 recordsLinked to original sources

Use of a computer software program for qualitative analyses--Part 2: Advantages and disadvantages.

NUD.IST 3.0 was generally effective in managing the qualitative data of dyspnea stimuli. Yet, some disadvantages were found related to format restrictions of transcripts and data volume. In particular, an appropriate format of transcripts for NUD.IST use was critical for efficient data management. Awareness of strengths and limitations of program functions is necessary to use NUD.IST efficiently in qualitative data management.

Abstracting and Indexing↗

Use of a computer software program for qualitative analyses--Part 1: Introduction to NUD.IST.

The NUD.IST (Non-numerical Unstructured Data Indexing, Searching, and Theorizing) program is recognized as one of the most efficient software programs for qualitative data analysis because it dramatically reduces the clerical tasks of cut and paste for coding and retrieval in text. However, little literature related to NUD.IST and its use in qualitative analysis is available to nurse researchers. Thus, the purposes of the first part of a two-part article are to describe the features of NUD.IST to nurse researchers and to present how NUD.IST was used in a qualitative study of dyspnea stimuli. In managing the qualitative data of dyspnea stimuli, NUD.IST 3.0 was effective in extracting, retrieving, and tracking text segments as well as identifying commonalties or patterns in data quickly.

Abstracting and Indexing↗

Evaluation. Closing the loop.

After implementing a new nursing care delivery system, evaluating its outcomes is essential. An evaluation process answers key questions: (1) Were planned outcomes achieved? (2) Were the users satisfied? (3) Does the delivery system need to be modified?

Acute Disease↗

Adult respiratory distress syndrome: outcome in a community hospital.

BACKGROUND: Published reports indicate that survival rates of patients with adult respiratory distress syndrome have not improved dramatically since the first report of the condition in 1967. However, changes in ventilator strategies and improved critical care management may result in better survival rates in patients with well-defined, severe adult respiratory distress syndrome. OBJECTIVES: To report the outcomes of patients with adult respiratory distress syndrome treated in a community hospital and compare these findings with those in previously published reports. METHODS: A retrospective study design was used. All patients diagnosed with adult respiratory distress syndrome (N = 47) over a 2-year period were studied. RESULTS: For the study patients, the survival rate was 64%; 29% died from respiratory failure alone. Analysis demonstrated that advanced age was not associated with mortality. Pressure-control ventilation was used for 31 patients and there was no significant difference in the presence of barotrauma in the pressure-control mode vs volume ventilation. CONCLUSION: This survival rate exceeds most recently reported rates and thus supports the idea that improvement in treatment of adult respiratory distress syndrome is occurring.

Adult↗

The cost of nursing excellence in critical care.

The results of the American Association of Critical-Care Nurses Demonstration Project support the contention that high quality critical care nursing can be provided to patients at a reasonable cost. In addition, the data refute the notion that elements influenced by nurses--supplies and nursing care--are the most costly portion of the total hospital charge.

Costs and Cost Analysis↗

Ineffective airway clearance related to artificial airway.

Ineffective airway clearance occurs when an artificial airway is used because normal mucociliary transport mechanisms are bypassed and impaired. Nursing assessment and intervention are the keys to maintaining airway patency in the patient with an artificial airway in place. The assessment of breath sounds is critical to making a valid clinical judgment about airway patency. Nursing interventions such as tracheobronchial suctioning, postural drainage, and providing exogenous humidity to the inspired air are indicated to maintain airway patency, which is the goal of treatment. Suggested areas for future research related to this diagnosis include validation of the signs and symptoms which are proposed as being specific to the causes of ineffective airway clearance and the continuation of experimental studies to demonstrate the efficacy of various interventions for this nursing diagnosis.

Female↗

Dyspnea self-management in African Americans with chronic lung disease.

PURPOSE: To explore dyspnea self-management in African Americans with chronic obstructive pulmonary disease (COPD) or chronic restrictive pulmonary disease resulting from sarcoidosis. DESIGN: Descriptive. SAMPLE: Convenience sample of 29 African Americans, 15 with COPD (forced expiratory volume in 1 second/forced vital capacity = 53%), and 14 with sarcoidosis (forced expiratory volume in 1 second/forced vital capacity = 88%; total lung capacity 62.4% of predicted). METHODS: Semistructured interviews. FINDINGS: Content analysis revealed 4 dyspnea self-management themes: (1) traditional medical care, (2) self-care wisdom, (3) self-care action, and (4) self-care resources. Breathing strategies (a subtheme for self-care action) for patients with COPD focused on both inhalation and exhalation, whereas patients with sarcoidosis described inhalation breathing strategies only. CONCLUSION: African Americans with chronic lung disease described use of different breathing strategies for COPD and sarcoidosis disorders. Both groups actively engaged in health-promoting activities for dyspnea management.

Black or African American↗

Dyspnea: a case for nursing diagnosis status.

Dyspnea, the unpleasant subjective sensation of difficult breathing, is one of the most common symptoms experienced by patients with pulmonary and cardiac disorders. This article reviews the research concerning dyspnea and proposes it for consideration as a nursing diagnosis. The etiologies are categorized according to the neurosensory, neurochemical, cognitive, and affective mechanisms. The defining characteristics include the subjective words describing dyspnea, such as shortness of breath, suffocation, and tightness. The most supported objective sign of dyspnea in the literature is an increased use of accessory muscles of respiration. Nursing interventions for dyspnea relief are geared toward reducing the afferent activity from receptors in the respiratory muscles and dealing with the affective component of dyspnea. These interventions include pacing activities, breathing techniques, and inducing the relaxation response. Because most research for interventions to reduce dyspnea have focused on patients with obstructive lung disorders who have chronic dyspnea, recommendations for further research include using acutely ill patients and those with a variety of medical conditions.

Dyspnea↗

The reliability of magnitude estimation for dyspnea measurement.

The reliability of magnitude estimation with an open scale was evaluated in a physiologically stable population of adults with chronic respiratory disease who experienced chronic dyspnea. Magnitude estimation was used to measure one dimension of dyspnea, perceptual sensitivity. The relationship between external inspiratory resistive loads (stimuli) and numbers that reflected the perceived intensity of the breathing effort (response) as expressed by a power function was measured on three visits 3 to 5 days apart. The correlations of the exponent of the power function between visits were high and stable.

Adult↗

Use of magnitude estimation for estimating the parameters of dyspnea.

Magnitude estimation, a psychophysic method, allows examination of variables associated with the respiratory sensation of loaded breaths. The subject's perceptual sensitivity can be quantified by magnitude-scaling exponents which describe the rate of growth of the dyspnea sensation associated with increases in the magnitude of the stimulus. Measurement of the perception of dyspnea by magnitude estimation can complement other measurements of variables that contribute to this complex sensation. Use of magnitude estimation techniques can enhance the study of similar clinical problems such as pain and fatigue.

Dyspnea↗