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Biomedical subjects

P M Schwirian

Publications and source records attributed to P M Schwirian.

At least 19 recordsLinked to original sources

Spousal caregivers' burden: impact of care recipient health problems and mental status.

1. Caregiver burden is a three-dimensional concept. It reflects the impact of caregiving on interpersonal relationships; expressions of caregiver anxiety; and the personal impact of the caregiver role. 2. In the study presented, mental impairment had the most significant negative impact on caregiver burden overall, as well as on each of the three components of burden--regardless of an impaired elder's physical problems. 3. Nursing strategies to improve the care of frail elders and their caregivers include the development and implementation of a sensitive discharge assessment and plan; articulation between the hospital-based and community-based nurses; and assessment of the caregiver-care receiver dyad.

Aged↗

Use of water pillows in reducing head shape distortion in preterm infants.

The purpose of this study was to determine the effectiveness of a water-pillow treatment in reducing bilateral head flattening of preterm infants. The subjects were 21 healthy infants of less than 36 weeks gestational+ age. Care of the experimental babies included supporting the head on a small water pillow and supporting the torso at the same level to avoid flexion or curvature of the spine; the control group received customary care. The ratios of the anterior-posterior diameter to the biparietal diameter were significantly different for the two groups (p less than .0005). The heads of the control infants became flattened on both sides, while those of the experimental babies maintained the round shape they had at admission to the unit. The findings support the use of a small water pillow, in combination with support for the torso, as a means of alleviating bilateral head flattening in preterm infants.

Beds↗

Intra-aortic balloon pumping and stress in the coronary care unit.

This study compared the perceptions of psychological stress experienced by patients on the IABP with that of other patients in the CCU. During 13 weeks, structured interviews were conducted with 17 male and 10 female patients: Seven were treated with the IABP; 10 were not on the pump but were present during its use; and 10 were neither on the pump nor in physical proximity to it. To measure psychological stress, each patient responded to a list of 20 potentially stressful situations using a stress rating scale. Analysis of variance was used to determine differences in perceptions. The results identified factors in the CCU that patients perceived as stressful and were compared with those of earlier research. Data analysis demonstrated moderate support for the study's hypotheses. Stress levels of patients on the IABP were significantly higher than those of patients who were not on the IABP but present during its use. No significant differences were found between stress levels of patients on the IABP and patients with the IAPB absent or between those of the two groups who were not on the pump. Implications for nursing care of the patient on the IABP were also discussed.

Adult↗

The relationship between caregiver burden and TBI survivors' cognition and functional ability after discharge.

This exploratory correlational clinical study examines the relationship between reported caregiver burden (as measured by the Burden Interview) and cognition and functional ability (as measured by the Functional Independence Measure instrument) of people who had experienced traumatic brain injury (TBI). The purpose of the research was to explore the impact of cognition and functional ability in adults with TBI on perceived caregiver burden. Forty-two subjects with TBI and their caregivers were studied during the follow-up clinic appointment 3 months after discharge from a 31-bed inpatient rehabilitation unit. Demographic data and relationships to previous studies were explored. Pearson correlation matrixes and a simple single regression model were used to examine the relationships. Functional ability and cognition both negatively affected reported caregiver burden, although the relationship was not statistically significant.

Activities of Daily Living↗

Direct sibling contact and bacterial colonization in newborns.

A two-phase, experimental study tested the hypothesis that no significant association exists between direct sibling contact and the bacterial colonization rates of neonates during their initial hospital stay. In Phase I, 44 infants were randomly assigned to experimental (N = 23) and control (N = 21) groups. Infants in the experimental group had direct contact with an older sibling who had been screened for communicable diseases; infants in the control group did not. The dependent variable, bacterial colonization, was measured using cultures of nasal and umbilical swabs of all neonates in the study. Swabs were taken at admission and discharge. In Phase II, the same procedures were followed except that swabs were taken from the neonates (N = 33 in each group) at admission, before the sibling contact, and at discharge. Analysis of the data using the standard error of the difference between proportions showed no significant differences in the proportion of infants colonized by staphylococcal and streptococcal organisms. Thus, bacterial colonization rates and older sibling contact were not associated. Implications for care and further research are discussed.

Adult↗

Microcomputers in a clinical nursing research program.

This article describes a model for a clinical nursing research program in a community hospital, some of the support roles that microcomputers can play in such a program, and some example studies conducted by nurse researchers with use of microcomputers.

Computers↗

Evaluating the performance of nurses: a multidimensional approach.

This article describes the development--including content, structure, validity, and reliability--of the Six-dimension Scale of Nursing Performance (Six-D Scale), which consists of a series of 52 nurse behaviors grouped into six performance subscales: leadership (5 items), critical care (7 items), teaching/collaboration (11 items), planning/evaluation (7 items), interpersonal relations/communications (12 items), and professional development (10 items). The scale may be used to obtain self-appraisals of performance, employer appraisals of performance, or perceived adequacy of nursing school preparation for performance. The case is made for the construct and pragmatic validity of the Six-D Scale, and all six subscales are shown to be highly reliable. The instrument was found to be suitable for performance evaluation as well as a useful research tool.

Clinical Competence↗

Computers in nursing practice. A comparison of the attitudes of nurses and nursing students.

This study was undertaken to compare the attitudes of nurses and nursing students toward computer use in nursing practice and to clarify factors that influence these attitudes. Three factors within the student sample were examined: changes over time, prior experience with computers, and attitudes toward technology in general. Second, the attitudes of the nursing students were compared with those of a sample of practicing nurses. Finally, the multidimensional structure of Stronge's attitude scale was analyzed. A total of 353 sophomore nursing students and 358 staff nurses participated in the study. The analysis produced a refined 17-item attitude scale composed of three identifiable subscales: computers and patient care, computers and personal security, and general attitude. It was found that students had less experience with computers than the investigators had anticipated, and there was little change over three successive cohorts of students. However, in general, students' attitudes toward computer use in nursing were positive, and the more computer experience students had, the more positive their attitudes. The attitudes of the practicing nurses also were generally positive, but differences between students and nurses were observed.

Attitude to Computers↗

Guidelines for reporting innovations in computer-based information systems for nursing.

Inconsistent, incomplete reporting of computer applications in nursing is a barrier to building a knowledge base in the field. Progress in building this knowledge base might be accelerated if system developers could use the available literature to build upon work previously done and to profit from lessons already learned. This article presents guidelines for developing articles and reports on computer applications in nursing. Important topics include statement of the problem, proposed solution, description of the system, system impact, relationship to previous work, problems encountered, lessons learned, professional issues, transferability, and future plans. A checklist is provided. The authors welcome comments on these guidelines.

Communication↗