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Biomedical subjects

P K Nicholas

Publications and source records attributed to P K Nicholas.

16 recordsLinked to original sources
PubMed2000

Long-term continuum of care for people living with HIV/AIDS.

The introduction of highly active antiretroviral therapy (HAART), has created new options for those infected and affected by human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS). Most HIV-infected persons no longer die within months of diagnosis. There is now a long-term continuum of care that can end in misery or relative comfort. The introduction of palliative care in concert with curative therapies throughout the disease trajectory should be the standard of care for all persons. At the very least, the introduction of palliative care and hospice at the end of life is important to the holistic care of persons living with HIV/AIDS.

Anti-HIV Agents↗
PubMed1999

Predictors of self-reported adherence in persons living with HIV disease.

This study examined the relationships between the five dimensions of the Wilson and Cleary model of health-related quality of life and three self-reported adherence measures in persons living with HIV using a descriptive survey design. Data collection occurred in seven cities across the United States, including university-based AIDS clinics, private practices, public and for-profit hospitals, residential and day-care facilities, community-based organizations, and home care. The three dependent adherence measures studied were "medication nonadherence," "follows provider advice," and "missed appointments." The sample included 420 persons living with HIV disease with a mean age of 39 years of which 20% were women and 51% were white; subjects had a mean CD4 count of 321 mm3. HIV-positive clients with higher symptom scores, particularly depression, were more likely to be nonadherent to medication, not to follow provider advice, and to miss appointments. Participants who reported having a meaningful life, feeling comfortable and well cared for, using their time wisely, and taking time for important things were both more adherent to their medications and more likely to follow provider's advice. No evidence was found demonstrating any relationship between adherence and age, gender, ethnicity, or history of injection drug use. These findings support the need to treat symptoms, particularly depression, and to understand clients' perceptions of their environment as strategies to enhance adherence. A limitation of this study was that adherence was measured only by self-report; however, the study did expand the concept of adherence in HIV care beyond medication adherence to include following instructions and keeping appointments.

Adult↗
PubMed1999

Hardiness, social support, and health status: are there differences in older African-American and Anglo-American adults?

The article reports a study examining the relationships among hardiness, social support, and health status in older African-American and Anglo-American adults (n = 110). The theoretical framework of the study was based on the interrelationships of the personal resources of hardiness, social support, health status, and sociodemographic factors, including race. Pearson's correlation coefficients and t tests were performed to examine the relationships among the variables. Hardiness correlated significantly with greater social support, better perceived health status, increasing age, and lower income. Social support correlated significantly with better perceived health status, increasing age, and higher income. Perceived health status correlated significantly with lower age. Older Anglo-American adults had significantly higher scores on hardiness, whereas older African-American adults had significantly higher scores on social support. Implications for holistic nursing practice are discussed.

Adaptation, Psychological↗
PubMed1997

Prostatitis: diagnosis and treatment in primary care.

Prostatitis refers to the inflammation and/or infection of the prostate gland, which occurs in several forms or syndromes and presents with varied etiologies, clinical features, and sequelae. The four common forms of prostatitis are acute bacterial prostatitis, chronic bacterial prostatitis, nonbacterial prostatitis, and prostatodynia. Differential diagnosis of prostatitis is based on history, physical exam findings, and, frequently, analysis of expressed prostatic secretions. Complaints may vary, but pain or discomfort in the rectal or perineal area is usually present. Clinicians in primary care settings should be knowledgeable about the types of prostatitis, etiology, and pathogenesis; the methods of diagnosis; and treatment/education issues.

Decision Trees↗
PubMed1996

Health care and nursing in Romania.

Health care and the nursing profession have been affected dramatically by political and socio-economic conditions in Romania. The Romanian Ministry of Health has recognized the health problems and barriers to care delivery which exist in the country, with several goals identified to improve the status of Romanian health care. This paper explores the critical issues which have impacted on health care and nursing in Romania.

Delivery of Health Care↗
PubMed1996

A behavioral medicine intervention in persons with HIV.

This study used a pretest-posttest preexperimental design to examine the effect of a 10-week behavioral medicine support group intervention in a sample of persons with HIV. Using Solomon's psychoneuroimmunologic framework, the 10-week behavioral medicine program focused on the mind/body interaction, the relaxation response, coping with illness, hardiness, and nutrition. Pearson correlation coefficients and t tests were performed on the pre- and postintervention measures of hardiness, social support, immune function, and perceived health status. Results of the study indicated that hardiness (preintervention) and CD4 counts (pre- and postintervention) were significantly correlated with health status; however, CD4 counts decreased over the course of the behavioral medicine program. Implications for nursing and recommendations for further research are discussed.

Adult↗
PubMed1995

Social support, quality of life, immune function, and health in persons living with HIV.

The purpose of this study was to examine the relationship between social support and quality of life in individuals with HIV. Using a descriptive, correlational design, data were collected from 50 HIV-positive individuals who were: (a) participants in support groups at a behavioral medicine unit, (b) inpatient or respite care patients with HIV, or (c) respondents to advertisements at AIDS service organizations. Instruments used for data collection were the Personal Resource Questionnaire 85-Part 2 (Weinert, 1987), measuring perceived social support, and the Quality of Life Index (QLI) (Ferrans & Powers, 1985), measuring the sense of well-being in life including the satisfaction with and importance of life domains with four subscales: health and functioning, socioeconomic, psychological/spiritual, and family. The results of the study indicated that social support was significantly correlated with quality of life (r = 0.81, p < 0.0001). Further, HIV status (asymptomatic HIV, symptomatic HIV, AIDS) was significantly related to quality of life (p < 0.01). However, HIV status was not significantly related to social support. No significant relationship was found between CD4 counts and HIV status, CD4 counts and social support, or CD4 counts and perceived health status. However, CD4 counts were significantly correlated with scores on the QLI. The findings of the study indicate that social support and quality of life are significantly intercorrelated and that higher CD4 counts are related to quality of life in this sample of persons living with HIV. Further areas for research include evaluation of quality of life over the span of HIV disease and interventions aimed at enhancing or maintaining quality of life in persons across the spectrum of HIV disease.

Adult↗
PubMed1995

Evaluation of a problem-based access knowledge system using triangulation methods.

A microcomputer-based system designed to provide nurses and physicians access to expert synthesized knowledge in the area of pulmonary arterial waveform troubleshooting has been developed and implemented. Evaluation using triangulation methods show that there was a substantive increase in knowledge in both nurses and physicians.¿.

Attitude of Health Personnel↗
PubMed1994

Prevalence and characteristics of pain in persons with terminal-stage AIDS.

A retrospective chart review was undertaken to collect and report data on the prevalence and characteristics of pain in persons with terminal-stage AIDS. A convenience sample consisting of 50 patient charts at a residential AIDS hospice was utilized. Data were collected from the McCaffery Initial Pain Assessment Tool (IPAT) (1983) which was completed at the time of each hospice admission. The IPAT is composed of 10 sections that collectively describe the patient's pain experience. Demographic and AIDS-related pathology data were also collected. Data were analysed using descriptive statistics to examine the incidence and characteristics of pain. Pain was experienced by a majority of the subjects in the sample. Pain levels for 'present pain', 'worst pain gets', 'best pain gets' and 'acceptable level of pain' are reported. Characteristics of pain including location, causal factors and verbal descriptors are reported. Implications for nursing practice and suggestions for further research are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Hardiness, self-care practices and perceived health status in older adults.

The purpose of this study was to examine the relationship among hardiness, self-care practices and perceived health status in older adults. A random sample of older adults (n = 72) was selected from the population of a small north-eastern town in the United States. Self-report data were obtained on the Health-Related Hardiness Scale as a measure of hardiness, the Personal Lifestyle Questionnaire as a measure of self-care practices and the Visual Analogue Scale as a measure of perceived health status. It was hypothesized that older adults who had higher levels of hardiness and self-care practices would have a higher perceived health status and that hardiness and self-care practices combined would explain more of the variance in perceived health status than either variable taken individually. Statistical analyses supported the three hypotheses. The obtained significant correlation between hardiness and perceived health status was -0.68 (P < 0.001) (hardiness negatively scored). For self-care practices and perceived health status, the correlation was 0.46 (P < 0.001). The illness index, income and living circumstance accounted for 46% of the variance in perceived health status scores. Hardiness and self-care practices accounted for an additional 10% of the variance in perceived health status once these demographic and illness variables were controlled. Implications for nursing practice, education and research are discussed. Recommendations included replication of the study with a larger, more heterogeneous population. Suggestions for further investigation of the relationship between resistance resources such as hardiness and self-care practices and health status are presented.

Adaptation, Psychological↗
PubMedDate not supplied

Predictors of perception of cognitive functioning in HIV/AIDS.

This is a descriptive, correlational study of the predictors of perceived cognitive functioning. The convenience sample of 728 nonhospitalized persons receiving health care for HIV/AIDS was recruited from seven sites in the United States. All measures were self-reported. Self-perception of cognitive functioning, the dependent variable, was composed of three items from the Medical Outcomes Study HIV scale: thinking, attention, and forgetfulness. Data related to age, gender, ethnicity, education, injection drug use, CD4 count, and length of time known to be HIV-positive were collected on a demographic questionnaire. The scale from the Sign and Symptom Checklist for Persons with HIV Disease was used to measure self-reported symptoms. Data were analyzed using hierarchical multiple regression analysis. Predictors of perception of cognitive functioning explained a total of 36.3% of the variance. Four blocks--person variables (1.5%) (age, gender, education, history of injection drug use), disease status (2.3%), symptom status (26.5%), and functional status (5.4%)--significantly contributed statistically to the total variance. Among those individuals who completed the questions related to depression (n = 450), 28% of the variance in cognitive functioning was explained by this variable. The findings in this multi-site study indicate that symptom status explained the largest amount of variance in perceived cognitive functioning. Early identification of cognitive impairment can result in appropriate clinical interventions in remediable conditions and in the improvement of quality of life.

Adult↗
PubMedDate not supplied

Self-care burden in women with human immunodeficiency virus.

The authors of this descriptive study used Orem's Theory of Self-Care to assess perceived demand for or change in universal and health-deviation self-care activity and the degree of difficulty ascribed to meeting that demand. Perceived demand or change in self-care and difficulty in self-care were measured using the Self-Care Burden Scale (Oberst, Hughes, Chang & McCubbin, 1991) and a structured interview. A convenience sample of 10 English or Spanish-speaking women with HIV infection utilizing a city hospital's outpatient immunodeficiency clinic were recruited. Of the health deviation self-care items, home medical/nursing treatments, special diet, and obtaining resources were the most burdensome categories. Universal self-care tasks with the highest burden scores were caring for children, physical activity, and work.

Adaptation, Psychological↗
PubMedDate not supplied

A collaborative program for international education.

A collaborative educational program for Japanese nurses was developed, which merged the resources of the practice and education settings at the Massachusetts General Hospital (MGH) and the MGH Institute of Health Professions. Two concurrent programs were developed--Adult Health and Maternal-Child Health. These concurrent programs focused on content reflecting key areas in the realm of nursing practice and education in both Japan and the United States. Complementary clinical tours were an integral part of the program. This dyad of lecture and clinical experiences provided a forum to focus on issues relevant to nursing worldwide.

Humans↗