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Biomedical subjects

M Schoessler

Publications and source records attributed to M Schoessler.

11 recordsLinked to original sources
PubMed1999

The experience of life-threatening illness: patients' and their loved ones' perspectives.

BACKGROUND: Little is known about the actual concerns of patients and families regarding their health care during life-threatening illness and at end of life. Previous research with these groups has focused on their reaction to concerns of the medical community, eg, advance directives, decision making, and pain and symptom management. OBJECTIVE: To elicit and listen attentively to the actual experiences and major concerns of persons with life-threatening illness, personal/family caregivers, and bereaved individuals regarding their health care and interactions with healthcare system. DESIGN: Thirty-three focus groups were convened to involve 3 categories of individuals: persons with life-threatening illness (n = 77), personal/family caregivers (n = 70), and bereaved persons (n = 81). Three focus groups, 1 of each kind, were held in 11 cities across the United States. Verbatim transcripts were coded and analyzed to identify themes. RESULTS: (1) Persons with life-threatening illnesses indicated that health professionals focus on medical and physical interventions, give too little information, appear uncomfortable talking about death, and do not include family members in conversations. (2) Caregivers reported exhaustion. They said that doctors do not appreciate the impact of the illness on their lives and rarely consult them, although all treatment decisions affect them. (3) Bereaved persons emphasized the loved ones' comfort in the last days of life. They wished that physicians would tell families when the end is near and avoid interrupting the process of dying with medical and often futile tasks. "I'm sorry" is sufficient initially to express the physician's condolences, but families appreciate contact weeks later. CONCLUSIONS: Many sources of dissatisfaction with care among persons with life-threatening illness and their families are interpersonal in nature. The physician's respectful presence and demonstration of caring are highly desired, significant interventions for those who cannot be cured of illness and for their loved ones. Making healthcare professionals aware of these concerns may itself bring about some changes in daily practice. Further research is needed to test the most useful skills and behaviors of healthcare professionals in caring for persons with life-threatening illness and their loved ones.

Journal Article↗
PubMed1995

Organizational transition: managing through rough waters.

Managing during restructuring is a little like managing during a tidal wave or an earthquake. The environment is turbulent, unpredictable, often personally threatening, and laden with long term consequences. As in a natural disaster, you must plan ahead, keep the short term in focus, and the long term in perspective.

Adaptation, Psychological↗
PubMed1991

A description of patient and nurse perceptions of preoperative teaching.

While research has shown preoperative teaching to be an essential nursing activity, it has become increasing difficult to accomplish. Increased outpatient surgery and morning admission on the day of surgery have reduced time available for assessment and preparation activities including teaching. In this study, 116 postsurgical patients and 159 hospital-employed nurses completed an investigator-developed questionnaire. The statements were written to operationalize the five dimensions of preoperative teaching: psychosocial support, situational information, patient role, sensation--discomfort, and skills training. For each of the questionnaire statements, subjects were asked to: (1) rate the importance of a 5-point Likert-type scale ranging from "not important" to "very important" and (2) indicate the preferred timing for teaching to occur: before admission to the hospital, between admission and surgery, or at the time of the event. Patients also indicated whether they received the teaching from a nurse. Mean ratings of importance for both groups ranged from moderately important to important with the nurses reporting the wider range of importance. Analysis showed a discrepancy between nurse and patient rank orderings as determined by mean ratings of importance. Patients rated the order of importance as listed above, which is parallel to the reported frequency of receiving instruction. The two groups differ in the ordering only in the placement of skills training. Nurses placed skills training second; patients placed it last. Both groups preferred delivering and receiving teaching between admission to the hospital and surgery. Independent t test results indicated nurses assigned more importance to psychosocial support and skills training than did patients; patients assigned more importance to sensation--discomfort than did nurses.

Adolescent↗
PubMed1989

Perceptions of pre-operative education in patients admitted the morning of surgery.

This study is one of the first to examine patient perceptions of the importance of dimensions of pre-operative education and preference for timing of instruction when patients are admitted to the hospital the morning of surgery. Data were collected from 116 patients through a paper-pencil survey developed by the investigators. Results indicate that patients believe all five dimensions of pre-operative education are moderately important to receive. Of the five dimensions of pre-operative education, psychosocial support and situational information were rated as the most important dimensions to receive. Patients indicated a preference for receiving education between admission to the hospital and the time of surgery. Information about patient preferences for timing of education and perception of importance of types of teaching will assist health care providers in planning pre-operative patient education programs to best meet the perceived needs of the patient population.

Adult↗
PubMed1985

Continuing education for hospice staff.

Hospice nursing is unique because of the philosophy and issues surrounding hospice care. Program planning for hospice staff follows basic principles. The real challenge in developing programs for orientation, continuing, and inservice education is using a format that will truly enable staff to meet the objectives. A lecture, programmed instruction, or video/slide format works well for the "nuts and bolts," but more creativity is needed for the other issues facing the hospice nurse--death, grief, symptom control, stress, team roles, and helping patients with options. Incorporating into the program some of the methods suggested will offer staff the opportunity to become involved in learning and make that learning more meaningful.

Curriculum↗
PubMedDate not supplied

Preparing documentation for a JCAHO visit.

This article describes a documentation format for Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) standard 6. A system for maintaining ongoing documentation is presented. Once in place, only a few "last minute" items need preparation prior to a JCAHO visit. In the weeks preceding the visit, department members can review the materials for accuracy and completeness and ensure that the document adequately reflects the extent and quality of the department's activities. The system is easily adapted to changes in JCAHO standards.

Accreditation↗
PubMedDate not supplied

Use of the Myers-Briggs Type Indicator to develop a continuing education department.

Myers-Briggs concepts are useful for understanding and managing individual and group strengths, preferences, and "blind spots." Requirements of the work to be accomplished can be matched to the strengths and preferences of the individual or group. Work groups can be selected to enhance individual strengths and to counterbalance blind spots. This article describes the experience of one hospital-based continuing education department that uses the Myers-Briggs Personality Trait Inventory to explore department members' strengths and preferences. Understanding individual preferences has helped group members to understand, anticipate, and work with one another. The ideal mix of profiles challenges and stimulates both the individual and the department. Maximizing diversity increases the potential for conflict between individuals with opposite preferences; recognizing strengths and blind spots, willingness to talk about work style differences, and a little humor all make peaceful coexistence possible.

Education, Nursing, Continuing↗