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PubMedDate not supplied

Needs of relatives of critically ill patients: a descriptive study.

Relatives of critically ill patients were able to identify their needs during the intensive care phase of hospitalization. The universal need identified as very important was the need for hope. Other important needs were concerned with receiving adequate and honest information and feeling that the hospital staff members were concerned about the patient. Although several of the needs appeared to be of great concern to relatives, all the needs were considered very important by at least one relative. The majority of needs were perceived as being met consistently. Various resources were used by the relatives to meet their needs; however, specific needs were expected to be met by physicians and nurses. Since many relatives have similar needs, the use of a group process to deal with them should be investigated. A group process allows for sharing and support among the relatives and also allows one staff member to work with several relatives. The relatives perceived the role of health care personnel to be patientcentered only. If the patient is a member of a family, then the family and staff should recognize that the health care personnel are helping relatives because it is a crucial part of total patient care. This area in providing total patient care needs to be studied carefully. The relatives of critically ill patients have important needs in this crisis period. By recognizing these needs and evaluating how they are being met, total patient care will involve the family. Such involvement is essential to the care of the critically ill patient.

Adolescent↗
PubMed2004

Cultural models of illness and recovery in breast cancer support groups.

In an ethnographic study of breast cancer support groups for white women, the authors describe the cultural model of illness and recovery espoused by the groups and examine contested areas that might influence participation. Through analysis of interviews, observation at meetings, and program documents, they develop a model of group culture that includes five components: recovery narrative, group metaphors, perceived benefits, group processes, and contested domains. The recovery narrative focuses on optimism and personal growth, and members invoke metaphors of family and sisterhood to describe their relationship to the group. Linkages are made between perceived benefits and group processes. Contested domains challenge dominant features of the recovery narrative. The authors discuss the value of cultural studies of illness support groups for understanding member-group fit.

Adult↗
PubMed2003

Using a focus group methodology to gain input from people who use home and community based services.

Gaining input from people who use home and community based services is important for determining the usefulness of services and clarifying future direction. Many of the commonly used methods have drawbacks when gaining input from people served. The current paper describes a focus group process that has been used to gain input from people who use home and community based services. The focus group process included designing the focus groups, their implementation, and feedback to stakeholders. Insights are presented and have implications for home and community based administrators, providers, and health care specialists.

Community Health Services↗
PubMed1984

[Documentation and control of the change process in group psychotherapy].

The practicabilites of applying methods for the representation and control of defined process data from a pragmatic aspect are described, and the significance of some methods to interpret a relevant therapeutic situation as well as to reveal the result obtained in therapy is specified. The actual possibilities to mathematicise the individual process characteristics apply to the definitions of three phases of therapy and permit to determining certain constellations in terms of being beneficial to or an obstacle for therapy. From this follow the relatively objective elements for supervision, in particular the qualification of group trainers within a uniform model of therapy and settings.

Documentation↗
PubMed2005

Predictors of engagement and retention into a parent-centered, ecodevelopmental HIV preventive intervention for Hispanic adolescents and their families.

OBJECTIVE: This study examined predictors of engagement and retention into a parent-centered, ecodevelopmental HIV preventive intervention for Hispanic adolescents and their families. The influence of retention on changes in adolescent HIV-risk attitudes was also examined. METHODS: Participants in this study were 91 Hispanic adolescents and their primary parents. Structural equation modeling was used to identify (a) predictors of initial engagement, (b) the effects of group processes on retention, and (c) the effects of retention on change HIV-risk attitudes in adolescents. RESULTS: Although some participant characteristics predicted engagement, the parent-facilitator relationship quality at the initial contact was found to be the strongest predictor of engagement. Furthermore, within-group processes such as group cohesion positively predicted retention. Finally, parent retention predicted decreases in adolescent HIV-risk attitudes. CONCLUSIONS: The results may have important implications for engagement and retention in parent-centered interventions, as well as for reducing risks for HIV transmission in Hispanic adolescents. Implications for services research are also discussed.

Adolescent↗
PubMed1999

Understanding triadic and family group interactions during infancy and toddlerhood.

This paper outlines recent conceptual and methodological developments in the assessment of triadic and family group process during infancy and toddlerhood. Foundations of the emerging family group process are identified, and conditions specific to the assessment of the family during the early phases of family formation are summarized. Both microanalytic and global approaches to evaluating mother-father-child interactions are discussed. We highlight both similarities and differences in the strategies and methods employed by several different investigators who have been studying the group dynamics of families with infant and toddler children, and underscore several important family patterns and emerging themes that appear to be cutting across these different methods and measurement strategies. Preliminary evidence for the validity and clinical significance of family-level assessments is summarized, and directions currently being pursued by researchers engaged in studies of the family triad are outlined. We close by identifying several conceptual and clinical issues that remain to be addressed by subsequent work.

Child, Preschool↗
PubMed2000

CD34+ selection of hematopoietic blood cell collections and autotransplantation in lymphoma: overnight storage of cells at 4 degrees C does not affect outcome.

The purpose of this study was to investigate whether storing mobilized peripheral blood progenitor cell (PBPC) collections overnight before CD34+ selection may delay platelet count recovery after high-dose chemotherapy and CD34+-enriched PBPC re-infusion. Lymphoma patients underwent PBPC mobilization with cyclophosphamide 4 g/m2 i.v. and G-CSF 10 microg/kg/day subcutaneously. Patients were prospectively randomized to have each PBPC collection enriched for CD34+ cells with the CellPro CEPRATE SC System either immediately or after overnight storage at 4 degrees C. Thirty-four patients were randomized to overnight storage and 34 to immediate processing of PBPC; 15 were excluded from analysis due to tumor progression or inadequate CD34+ cell mobilization. PBPC from 23 patients were stored overnight, while 30 subjects underwent immediate CD34+ selection and cryopreservation. Median yield of CD34+ enrichment was 43.6% in the immediate processing group compared to 39.1% in the overnight storage group (P = 0.339). Neutrophil recovery >500 x 10(9)/l occurred a median of 11 days (range 9-16 days) in the overnight storage group compared to 10.5 days (range 9-21 days) in the immediate processing group (P = 0.421). Median day to platelet transfusion independence was 13 (range 7-43) days in the overnight storage group vs 13.5 (range 8-35) days in those assigned to immediate processing (P = 0.933). We conclude that storage of PBPC overnight at 4 degrees C allows pooling of consecutive-day collections resulting in decreased costs and processing time without compromising neutrophil and platelet engraftment after infusion of CD34+-selected progenitor cells. Bone Marrow Transplantation(2000) 25, 559-566.

Adolescent↗
PubMedDate not supplied

The psychodynamics of the "holiday syndrome".

The holiday season is clearly a time of great emotional conflict, especially for schizophrenics. Both the occurrence of the holiday season and the psychoanalytic group process itself stimulate regression in the schizophrenic which uncovers the frustration and anger associated with dependency needs. The therapist who understands the pychodynamics set in motion by the holidays and by psychoanalytic group pschotherapy can utilize the content of group interaction during the holiday season to stimulate group process, the expression of mutual concerns, and cohesion among the members.

Anger↗
PubMed1997

Automatic extraction and measurement of leukocyte motion in microvessels using spatiotemporal image analysis.

This paper describes a computer vision system for the automatic extraction and velocity measurement of moving leukocytes that adhere to microvessel walls from a sequence of images. The motion of these leukocytes can be visualized as motion along the wall contours. We use the constraint that the leukocytes move along the vessel wall contours to generate a spatiotemporal image, and the leukocyte motion is then extracted using the methods of spatiotemporal image analysis. The generated spatiotemporal image is processed by a special-purpose orientation-selective filter and a subsequent grouping process newly developed for this application. The orientation-selective filter is designed by considering the particular properties of the spatiotemporal image in this application in order to enhance only the traces of leukocytes. In the subsequent grouping process, leukocyte trace segments are selected and grouped among all the segments obtained by simple thresholding and skeletonizing operations. We show experimentally that the proposed method can stably extract leukocyte motion.

Algorithms↗
PubMed1999

The team meeting on a rapid turnover psychiatric ward: clinical illustration of a model for stages of group development.

This article illustrates stages of group development in a semi-structured team meeting of staff and patients in an inpatient psychiatric unit. Clinical material drawn from such a group at the Massachusetts Mental Health Center is presented in support of the view that, even in a rapid-turnover ward, group process in a mixed-level, mixed-diagnosis "ward meeting" follows some predictable lines and responds to the articulation of certain predictable concerns. Garland's (1981) model of group development is adapted to show the cyclical nature of group process in a teaching hospital, where doctors as well as patients may make only brief stays. Effective leadership strategies are suggested.

Group Processes↗
PubMed1998

Affect and therapeutic process in groups for chronically mentally ill persons.

A dynamic group treatment model for chronically ill persons allowing them to determine the frequency of attendance empowers the members and potentiates group development. This format respects patients' needs for space as represented by missed meetings. In this context, absences are formulated as self-protective and self-stabilizing acts rather than as resistance. In an accepting, supportive environment, members can be helped to explore affects and gain insight into their behaviors. A clinical example illustrates patients' examination of the meaning of missing and attending sessions, with particular focus on intensity of involvement, autonomy, and control. In the process of testing the therapist and group, members show capacity to gain insight into recent in-group and extra-group behaviors.

Adult↗
PubMed2005

Biochemical investigation of pikromycin biosynthesis employing native penta- and hexaketide chain elongation intermediates.

The unique ability of the pikromycin (Pik) polyketide synthase to generate 12- and 14-membered ring macrolactones presents an opportunity to explore the fundamental processes underlying polyketide synthesis, specifically the mechanistic details of chain extension, keto group processing, acyl chain release, and macrocyclization. We have synthesized the natural pentaketide and hexaketide chain elongation intermediates as N-acetyl cysteamine (NAC) thioesters and have used them as substrates for in vitro conversions with engineered PikAIII+TE and in combination with native PikAIII (module 5) and PikAIV (module 6) multifunctional proteins. This investigation demonstrates directly the remarkable ability of these monomodules to catalyze one or two chain extension reactions, keto group processing steps, acyl-ACP release, and cyclization to generate 10-deoxymethynolide and narbonolide. The results reveal the enormous preference of Pik monomodules for their natural polyketide substrates and provide an important comparative analysis with previous studies using unnatural diketide NAC thioester substrates.

Amino Acid Sequence↗
PubMedDate not supplied

An emancipatory study of contemporary nursing practice.

Changes in health care facilities have created the necessity for individual nurses to change, eg, change jobs, pursue additional education, become independent entrepreneurs. There is a shortage of nurses that places stress on those who remain to care for an increasing number of persons with too few resources. The purposes of this study were to explore nurses' perceptions of the circumstances of their work lives and to describe the processes by which they can create change in these circumstances. The methodology was an emancipatory design combining tenets of critical inquiry and feminist research. The method used was a dialectical process of reflection and action (praxis). Three diverse groups of nurses met weekly over 6-10 weeks. Using the group process method, each group reflected on, discussed, and analyzed the phenomenon of practicing nursing today. The outcome of an emancipatory study is reflected in the power of the process. The group interaction increased awareness, promoted reflection on the status quo, and energized the groups to derive possible solutions to changing that status quo. It is not the solutions themselves that are as relevant as is the obvious cogency of the process to achieve individual and group emancipation. Six codifications reflected the themes that emerged and 5 processes for exploring untested feasibilities for change were identified. The participants perceived themselves more as subjects in their history than objects to be manipulated, capable of transforming a rather dismal situation of nursing practice into one that was critical, creative, and freer from constraints. The implication of this study is that nurses are encouraged to adopt and adapt this process of group interaction because of its demonstrated credibility to empower and validate the role that nurses have to derive and implement solutions to change their unsatisfactory status quo.

Attitude of Health Personnel↗
PubMed1998

Hospital uses team approach to improve processes, reduce costs.

This article describes a group process and how it was used to reduce reprocessing turnover time and increase the availability of sterilized instruments. A team of staff members used the "Seven Steps to Quality" and an event-related sterility maintenance program, thereby improving patient care and reducing costs. With a defined process, the team members' expertise, and clearly defined objectives and goals, the team was able to complete its work and implement a substantial change in a short amount of time.

Group Processes↗
PubMed1996

A method for checking regression models in survival analysis based on the risk score.

We propose to perform model check for the Cox and Aalen regression models using martingale residual processes grouped after the risk score. Asymptotic distributions of the grouped martingale residual processes are deduced, so both formal and graphical model check can be performed. The method is validated by stochastic simulation. A data example with patients with primary biliary cirrhosis of the liver is discussed.

Humans↗