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Biomedical subjects

Susan Williams

Publications and source records attributed to Susan Williams.

34 records · Page 2Linked to original sources
PubMed2005

Developing leadership skills in critical care nurses: a case scenario--part two.

During a recent CACCN board meeting, directors were challenged with developing an approach to a difficult case scenario. In a situation in which a group of nurses have angered some of the other nurses who work in the same unit, the directors were asked to identify core problems and suggest possible solutions and potential barriers to this problem. The perception that patient care is hampered, poor morale and job satisfaction as well as the lack of leadership and poor communication were identified as the core problems in the scenario that was presented. A number of possible solutions and the associated strengths and weaknesses, as well as the barriers to implementing the solutions were identified. In summary, critical care nurses must continue to advocate and lead the way toward strong leadership, modeling of appropriate behaviour and effective communication--all of which contribute to stronger team development and, ultimately, result in better, safer patient care.

Attitude of Health Personnel↗
PubMed2004

The validity of transvaginal ultrasound measurement of endometrial thickness: a comparison of ultrasound measurement with direct anatomical measurement.

OBJECTIVES: To compare transvaginal ultrasound measurements of endometrial thickness with direct anatomical measurements and consider the implications of these findings on clinical practice. DESIGN: Prospective observational study using two modalities blinded to each other's findings. SETTING: Singleton Hospital, Swansea, a medium-sized District General Hospital. SAMPLE: Forty-seven women admitted for hysterectomy. METHODS: All women underwent transvaginal ultrasound scan to measure the endometrial thickness within 16 hours of surgery. Anatomical measurement of the fresh specimen was carried out immediately after surgery. MAIN OUTCOME MEASURES: Agreement between ultrasound and anatomical measurements of the endometrial thickness. RESULTS: No ultrasound measurement was possible in 15% of patients. When both values were obtained, transvaginal ultrasound measurements were > 2 mm different from the ruler measurement in 13/40 (33%) with an obvious tendency of the ultrasound scan to over-estimate the endometrial thickness. The mean difference between the two measurements was -0.8 mm (limits of agreement -7.1 to +5.5 mm). The discrepancy was greater in women with endometrial thickness < or = 5 mm (-1.6 mm, limits of agreement -5.7 to +2.6 mm) compared with that in women with endometrial thickness > 5 mm (-0.2 mm, limits of agreement -7.6 to +7.2 mm). Kappa statistics showed good agreement between the two measurements in discriminating between thin and thick endometrium in 77% (kappa = 0.55). Transvaginal ultrasound misdiagnosed a thick endometrium as thin in 3/40 (8%) and misdiagnosed a thin endometrium as thick in 6/40 (15%). CONCLUSIONS: Transvaginal ultrasonography is of limited value as a screening test for abnormal endometrium in patients with postmenopausal bleeding if the only parameter of normality is an endometrial thickness of 5 mm or less.

Adult↗
PubMed2004

The race gap in support group participation by breast cancer survivors: real or artifact?

Addressing methodological weaknesses of previous research, this study assesses whether African American women are, in fact, less likely to participate in breast cancer support groups than are White women. Of the breast cancer survivors, 958 (26% African Americans, 73% Caucasian) completed interviews concerning demographic characteristics, other support networks, effects of illness on home and spiritual life, and support group participation. Contrary to previous research, no race difference was found in support group participation. This research suggests more effort needs to be paid to sampling techniques and other methodological factors to adequately reflect the experiences and needs of breast cancer survivors, specifically African American women.

Black People↗
PubMed2004

Evaluation of a children's temper-taming program.

OBJECTIVE: To examine the effectiveness of a group cognitive-behavioural therapy program in reducing anger and aggressive behaviour in children. METHOD: Study participants were 68 children aged 7 to 13 years and their parents. A total of 12 groups were run at an outpatient children's mental health centre. The children were referred to the groups by their clinician for assistance in reducing their aggressive behaviour. We obtained quantitative information on the effectiveness of the group from the children and their parents, who completed questionnaires before the first session and after the last session. The children completed the Children's Inventory of Anger (CIA), and the parents completed the Children's Hostility Inventory (CHI). We used t tests and analyses of covariance to test for posttreatment differences. RESULTS: Results were available for 56 children. At posttreatment, children reported that the intensity of their anger had decreased (CIA, t41 = 4.39, P < 0.0001), and parents indicated a reduction in the frequency of aggression (CHI-Aggression, t44 = 2.82, P < 0.01) and hostility (CHI-Hostility, t44 = 4.93, P < 0.0001) in their children. CONCLUSIONS: The group program appeared to reduce children's anger and aggression. However, the results are preliminary, and further controlled evaluation is required.

Adolescent↗
PubMed2003

Effect of the critical care outreach team on patient survival to discharge from hospital and readmission to critical care: non-randomised population based study.

OBJECTIVES: To determine the effect of the critical care outreach team on patient survival to discharge from hospital after discharge from critical care and readmission to critical care. DESIGN: Non-randomised population based study. SETTING: Tertiary referral teaching hospital with 1200 beds. PARTICIPANTS: Patients discharged from the critical care unit after their first or only admission for two study periods, 26 February 2000 to 25 February 2001 and 26 February 2001 to 25 February 2002. MAIN OUTCOME MEASURES: Survival to discharge from hospital after discharge from critical care and readmission to critical care. RESULTS: The introduction of a critical care outreach team improved survival to discharge from hospital after discharge from critical care by 6.8% (risk ratio 1.08). Readmission to critical care decreased by 6.4% (0.48). CONCLUSIONS: The activity of the critical care outreach team seems to improve patient survival to discharge from hospital and may reduce the number of readmissions to critical care.

Aftercare↗
PubMed2003

The psychosocial aspects of donating blood stem cells: the sibling donor perspective.

The collection of peripheral blood progenitor cells (PBPC) by apheresis has become common in related allogeneic donors. However, the acceptability of the procedure to donors has not been documented. The purpose of this baseline case series study was to evaluate the psycho-social dimensions of apheresis from the perspective of healthy sibling donors and to explore issues surrounding fully informed consent including voluntary donation. At the first interview to discuss donation, 17 consecutive human leucocyte antigens (HLA) identical sibling donors who chose to donate PBPC were recruited to the study. They then completed both scales of the State-Trait Anxiety Inventory. The state scale was completed again immediately before first apheresis. At the end of the final apheresis, the donors were interviewed again by an independent researcher using a standardised questionnaire. All aspects of the procedure were well tolerated, including levels of anxiety and pain. Donors donated even if the relationship with their sibling was poor. However, some areas for improvement were highlighted. Eight (47%) donors were asked to donate by their sibling or another close relative, and this gave them no real volunteer status. Written information was judged important by 11 (65%) donors, but the material used was limited. The possibility of a poor outcome for the recipient was not well understood. The content of the written documentation and the management of confidentiality in terms of donor volunteer status needed to be addressed. A further study regarding the follow-up needs of donors, including those where the outcome is poor, is underway.

Adult↗
PubMed2003

A pilot study of a parent-education group for families affected by depression.

OBJECTIVE: This study assessed the feasibility and efficacy of a parent-education group for families with young children and a parent with depression. We designed the program to be readily disseminated if shown to be effective. METHOD: We recruited 44 parents with depression from clinics and family doctors in Hamilton, Ontario, and randomly assigned them to receive the parenting program or to a wait-list control group. The outcomes measured included knowledge of depression, parenting, family relationships, depression symptoms, child depressive symptoms, and functioning. We used analysis of covariance to test for posttreatment differences between experimental and control groups. RESULTS: Of the treatment group, 27% dropped out at posttreatment, and 43% by follow-up. Those who dropped out had more severe depression at baseline than did those who completed the program, and there was selective loss of parents with more severe depression in the experimental group. In intention-to-treat analyses at posttreatment, probands in the experimental group reported more improvements on family functioning, parenting sense of competence, and family and parent conflict than did control subjects. Standardized effect sizes (ES) were medium (0.4 to 0.6). When baseline depressive symptom scores were controlled in the analyses, the between-group differences were reduced, showing that selective loss of participants may have influenced the findings. CONCLUSIONS: On balance, the results are encouraging and support the further development and evaluation of the group intervention. However, the study does not provide unequivocal evidence in support of the program. Before it is transferred to other settings, the program needs further modification to improve participation by parents with more severe depression and further evaluation of its effectiveness.

Adult↗
PubMed2002

Metacognitive awareness and prevention of relapse in depression: empirical evidence.

Metacognitive awareness is a cognitive set in which negative thoughts/feelings are experienced as mental events, rather than as the self. The authors hypothesized that (a) reduced metacognitive awareness would be associated with vulnerability to depression and (b) cognitive therapy (CT) and mindfulness-based CT (MBCT) would reduce depressive relapse by increasing metacognitive awareness. They found (a) accessibility of metacognitive sets to depressive cues was less in a vulnerable group (residually depressed patients) than in nondepressed controls; (b) accessibility of metacognitive sets predicted relapse in residually depressed patients; (c) where CT reduced relapse in residually depressed patients, it increased accessibility of metacognitive sets; and (d) where MBCT reduced relapse in recovered depressed patients, it increased accessibility of metacognitive sets. CT and MBCT may reduce relapse by changing relationships to negative thoughts rather than by changing belief in thought content.

Adult↗