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PubMed2004

The tyranny of consensus: implications for nursing education.

The egalitarian appeal of decision making based on consensus has been valued as a strong alternative to other decision making approaches such as voting. In this paper, we identify some of the challenges inherent in this view, and suggest consideration of alternative decision making approaches needed at times to help nurse educators in their work with students and colleagues. As nurse educators, we have a responsibility to educate students about the meanings of consensus, to encourage open discussion about implicit values underlying behaviors, and help them appreciate the importance of dissent in a democratic society. Our challenge is to ensure that we are using, and teaching, the best decision making process for the circumstance.

Communication↗
PubMed2003

The parent-adolescent relationship education (PARE) program: a curriculum for prevention of STDs and pregnancy in middle school youth.

The Parent-Adolescent Relationship Education (PARE) Program, designed for parents and middle school students, focuses on strengthening family communication about sexual issues and behaviors to help prevent teen pregnancy, human immunodeficiency virus (HIV), and other sexually transmitted diseases (STDs). The program includes content about reproduction, STDs and Acquired Immune Deficiency Syndrome (AIDS), contraception, sex risks, and safe-sex behaviors. The course uses social learning and cognitive behavioral concepts to enhance decision-making, refusal, and resistance skills. A randomized treatment or control group design is used to assign parent-child dyads to an experimental education group (social learning) or an attention-control group (traditional didactic teaching). Three post-program maintenance or booster sessions are held at 6-month intervals and at times prior to peak teen conception periods to reinforce the knowledge and skills learned. Pre- and posttests for parents and students assess group differences in parental involvement and communication, contraception, sex attitudes and intentions, sex behaviors (initiation of sexual intercourse, frequency, number of partners, contraceptive practices, refusal skills), and the incidence of pregnancy.

Adolescent↗
PubMedDate not supplied

Willingness of high school students to perform cardiopulmonary resuscitation and automated external defibrillation.

OBJECTIVE: To evaluate the willingness of high school students to perform cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED). METHODS: A convenience sample of high school students was surveyed regarding how they would respond if they witnessed a cardiac arrest. Participants were first shown a video segment on the operation of an automated external defibrillator. They were then shown a series of video clips depicting six different cardiac arrest scenarios: motor vehicle collision (MVC) with facial bleeding, pediatric drowning, intravenous (IV) drug user, choking family member, victim of differing race, and victim with facial vomitus. Following each video, the subjects were asked how they would respond had they actually witnessed a similar event. RESULTS: With parental permission and institutional review board approval, 683 students participated, representing 6.8% of the total student body. Of these, 585 (86%) were trained in CPR and 142 (21%) in AED. One hundred six participants (16%) had witnessed a cardiac arrest prior to the survey. Of these, 24 (23%) had intervened in some way. Twenty (19%) had performed mouth-to-mouth resuscitation (MMR), 15 (14%) had performed chest compressions (CC), and one (0.9%) had performed AED. Across all six mock scenarios and all 683 respondents collectively (4,098 simulated cardiac arrest events), the respondents indicated they would be willing to perform AED 1,308 times (32%). In comparison, the respondents indicated they would be willing to perform MMR 1,768 times (43%) and CC 2,249 times (55%). More respondents were willing to intervene on behalf of a child or family member, while fewer were willing to act in the setting of blood, vomitus, or an IV drug user (p < 0.05). There was no association between willingness to intervene and prior experience with any of the interventions. Fear of infection, legal consequences, and fear of harming the patient were the most frequently cited reasons for not intervening. CONCLUSIONS: Among high school students, few are willing to perform automated external defibrillation. Willingness to perform MMR and CC appears to depend on the circumstances.

Adolescent↗
PubMed2005

Making choices: how older people living in independent living units decide to enter the acute care system.

Older people living in independent living units make choices about where they live and the degree of support required to maximize their health and well-being. This can include when to enter the acute care system. Using a multimethod, multistage qualitative approach, this study aims to explore and describe the decision-making process of older people living in independent living units to enter the acute care system. Based on the findings, recommendations are provided which can ensure that older people do not enter acute care facilities until they need to, or if they do need to, they can access the care they require and leave with the best possible chance of not re-entering unnecessarily. The findings highlight that it is not enough to focus on the older person at the point of entry into the acute care system so the recommendations aim to assist in the development of best-practice initiatives for older people living in independent living units.

Acute Disease↗
PubMed2004

Postpartum practices and depression prevalences: technocentric and ethnokinship cultural perspectives.

Reports of non-Western prevalence of postpartum depression (PPD) are highly variable. This variation may indicate that the label of PPD may be unacceptable in some groups or not used, that manifestations may vary by culture, or that cross-cultural diagnostic standards do not match Western clinical criteria. These factors complicate efforts to explore the relationship of postpartum traditional practices to PPD between Western and non-Western cultures. Although Stern and Kruckman viewed PPD as a culture-bound phenomenon of Western culture, an expanding international literature has demonstrated that PPD occurs in a variety of countries. To address these issues, the authors examined the literature to describe cultural postpartum traditions, to explore possible relationships among practices and PPD prevalence, to critique the culture-bound theory, and to discuss clinical practice implications.

Attitude to Health↗
PubMedDate not supplied

Meeting the needs of siblings of children with cancer.

This study elicited the views of parents of children with cancer on siblings' needs and on support offered. A questionnaire obtained views from parents in 86 families (159 well siblings, mean age 10.5 years). Parents felt that current support was inadequate. Parents were willing for siblings to be involved in most therapeutic interventions; however, practicalities presented an obstacle to allowing their child's attendance. Parents who believed that their well child was likely to have problems as a result of the diagnosis were more willing (p < 0.004) and more able (p < 0.01) to take their child to therapeutic interventions. The weekend interventions and leaflets developed as a result of this study are described.

Adaptation, Psychological↗
PubMedDate not supplied

Nonpharmacological interventions with chronic cancer pain in adults.

BACKGROUND: Pain is often poorly controlled in cancer patients. Chronic pain affects adult patients at all stages of cancer management. Optimal pain management may require attention to psychosocial variables and the inclusion of nonpharmacological techniques. METHODS: Three nonpharmacological strategies that are effective in reducing pain caused by cancer--patient psycho-education, supportive psychotherapy, and cognitive-behavioral interventions--are reviewed. Recommendations for physicians to facilitate a mental health referral are also discussed. RESULTS: Effective treatment of cancer pain begins with assessing the severity, characteristics, and impact of pain. Emotional distress (especially anxiety, depression, and beliefs about pain) has emerged as predictive of patient pain levels. Appropriate pain management may require a multidisciplinary approach. CONCLUSIONS: Patient psycho-education has empowered patients to actively participate in pain control strategies. Supportive psychotherapy can assist patients in managing the stressors associated with cancer, and cognitive-behavioral therapy helps patients to recognize and modify the factors that contribute to physical and emotional distress.

Adult↗
PubMed2003

Behavioral treatment of obesity.

Behavioral treatment for obesity seeks to identify and modify eating, activity, and thinking habits that contribute to patients' weight problems. This approach recognizes that body weight is affected by factors other than behavior, which include genetic, metabolic, and hormonal influences. Behavioral treatment helps obese individuals develop a set of skills (eg, a low-fat diet, a high-activity lifestyle, realistic expectations) to regulate weight, even though patients may remain overweight after treatment. This article describes the behavioral treatment of obesity, its short- and long-term results, and methods to improve long-term weight loss.

Behavior Therapy↗
PubMed2005

Personality correlates of heroic rescue during the holocaust.

This study investigated the extent to which personality variables can be used to discriminate non-Jewish heroes of the Holocaust from bystanders and from a comparison group of prewar European immigrants who left their countries of origin prior to World War II. Eighty verified rescuers, 73 bystanders, and 43 immigrants were administered measures of locus of control, autonomy, risk taking, social responsibility, tolerance/authoritarianism, empathy, and altruistic moral reasoning. A three-group discriminant function analysis was able to correctly classify 80.2% of the sample by a combination of personality and demographic variables. When the bystanders and immigrants, who differed very little from each other, were grouped together and compared to the rescuers, the personality variables alone correctly classified 93.1% of the sample. Implications regarding the relationship between personality and altruistic behavior, as well as suggestions for future research are discussed.

Aged↗
PubMed2006

Rethinking the bystander role in school violence prevention.

Public concerns about school shootings and safety draw attention to the role bystanders can play in preventing school violence. Although school violence prevention plans are often required, there is little guidance about whether these should address the roles of bystanders and what actions bystanders should take in different circumstances, from more common instances of bullying and fighting to rare, but potentially lethal, threats and use of weapons. Literature pertaining to bystanders is reviewed and applied to the school setting. The definition of bystander is expanded, including parents, teachers, and other school staff as well as youths and those who have information about potential violence as well as those who witness its occurrence. Barriers preventing bystanders from taking positive actions are discussed. The authors call on health promotion researchers and practitioners to work with school communities to identify norms, attitudes, and outcome expectancies that shape bystander behaviors to inform prevention efforts.

Helping Behavior↗
PubMedDate not supplied

Helping patients with tinnitus: guidance for nurses.

It is no longer necessary for people with tinnitus to suffer, as self-help strategies are available. Nurses are in a position to provide information about tinnitus and help people to manage their condition. This article gives guidance for nurses produced by the British Tinnitus Association.

Activities of Daily Living↗
PubMedDate not supplied

Help us do it our way.

Explore the source record for details and available documents.

Community Participation↗
PubMed2002

Behavior-related modulation of substantia nigra pars reticulata neurons in rats performing a conditioned reinforcement task.

Motor-control models of basal ganglia function have emphasized disinhibition through reduction of tonic, inhibitory output. Although these models have shed important light on basal ganglia operations, evidence emerging from electrophysiological studies of behaving primates suggests that disinhibition alone may not adequately explain the role of the basal ganglia in movement. To assess this role in the rat, the most frequently used subject in studies of basal ganglia function, we recorded neuronal activity in the primary output nucleus, the substantia nigra pars reticulata, during an operant task. After rats were trained to nosepoke into an illuminated hole for access to a 10% sucrose solution delivered through a spout, single- and multiple-unit activity was recorded during 60-120 nosepoke trials. Compared to the period 60 s before the start of the first trial in the task, 110 of 225 reticulata units increased firing >200% while 17 of 225 decreased to 40% of baseline. Of these 225 units, >60% responded coincident with specific task events such as nosepokes and spout licking. Most nosepoke-responsive units showed either excitation (>50%) or a combination of excitation and inhibition (>25%) rather than inhibition alone (>20%). Increases in firing were also common during approach and licking at the spout, with inhibitions alone comprising 30% of responses. In some units, there was evidence of reward-related responding, with changes occurring in anticipation of reward delivery or during the delivery of sucrose, but not the persistent licking that continued for several seconds after its offset. While 70% of units responded during both nosepokes and spout licking, changes in firing were typically unique depending on the motor behavior required (i.e. nosepoking vs. licking). Our results, which indicate a prominent role for increases in nigra reticulata activity during movement, add to growing evidence that although inhibitions may allow desired motor responses to emerge, excitations may help shape behavioral output by suppressing competing motor programs.

Animals↗
PubMedDate not supplied

Electrophysiology of bimanual-bipedal automatisms.

To determine the localizing value and electrophysiology of bimanual-bipedal automatisms (BBAs), we studied these behaviors in 54 seizures of 8 patients with temporal or frontal lobe seizure onset. BBAs occurred with a frequency of 27% in frontal lobe epilepsy (FLE) and of 7% in temporal lobe epilepsy (TLE). The distribution of electrode sites showing ictal activity during these automatisms was significantly different in the two patient groups (0.0001 Chi-square). Mesio- and/or laterotemporal plus orbital frontal areas were involved areas when the behaviors appeared in patients with TLE; dorsolateral and mesiofrontal regions were the most commonly involved when the behaviors occurred during the course of frontal lobe seizures. We concluded that BBAs represent activation of frontal lobe circuitry but are not unique to seizures of frontal lobe origin. Eyelid flutter and repetitive body movements in either the axial or sagittal plane were significantly associated with the frontal lobe group whereas oral-alimentary automatisms were associated with the temporal lobe group. Thus, these associated behaviors may help indicate whether a frontal or temporal lobe seizure onset has occurred when BBAs are observed. A new concept of ictal expression is proposed to conform with the results as well as with other apparently disparate ictal behaviors that may have localizing value.

Adult↗
PubMed1992

[The patterns of the health care seeking behavior and related factors in the schizophrenic patients].

Three hundreds schizophrenic out-patients, from 6 different socioculture background psychiatric facilities in Hunan were investigated by structured interview with definite schedule. The results show that after the recognition of the problem by decision maker, 45% subjects were delayed at least one month for help-seeking, 61.3% subjects first visited the non-psychiatric agencies, and 74.3% subjects has counselled with non-psychiatric doctors or healers at least one time, especially to the healer providing superstitious or religious therapy. The help-seeking styles mainly attributes to the lower socioeconomic status of the family, inconvenient referral to the psychiatric facilities, especially if the decision maker is a female, rural resided under-educated person knowing nothing of modern psychiatry. Based on these findings, the authors urge to improve scientific psychiatric care knowledge in population, develop the resource of mental health service to facilitate the radical change of help seeking behavior of the population.

Female↗
PubMed2007

The soul of sorrow work: grief and therapeutic interventions with families.

The courage and willingness to walk alongside families in grief calls forth particular beliefs and practices in nurses and other health care professionals. In this second phase of a study on grief and grief interventions, the researchers examine experiences of bereaved family members who received care in a grief support program and explore program clinicians'explanations of the work that they do with the bereaved. Findings of this interpretive study suggest that it is not so much models of grief intervention but maps that most guide the clinicians--maps that are drawn out of experience and with awareness of their limitations. The family members and the clinicians bring us to an understanding that, often, it is the willingness to step off of the map that makes for the best traveling companion in the spiritual walk of grief.

Adaptation, Psychological↗