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PubMed1991

Needs of families of critically ill patients: a literature review.

More research is needed to assess and address all areas of concern to family members. Options such as family discussion groups, patient-family or psychiatric liaison nurses, or clinical nurse specialist involvement might be used to improve family care and coping. Family perceptions of important needs warrant further research, and nursing interventions such as orientation-education programs, descriptive visitor pamphlets, nurse-family interaction sessions, and open or flexible visiting policies need additional investigation. It is only through continued assessment, evaluation, and intervention that critical care nurses can achieve total care for the ICU patient and family.

Critical Care↗
PubMedDate not supplied

Designing an AIDS information campaign to reach intravenous drug users and sex partners.

Intravenous drug users are currently the second largest group to have developed the acquired immunodeficiency syndrome in the United States and Europe. Clearly, health communication plays an important role in the development of AIDS prevention programs directed at IV drug users. However, few public information campaigns have been developed to reach IV drug users or their sexual partners. In a recent campaign directed at these groups, the selection of messages to be used was based both on theory and on research into multi-media public information campaigns. The attempt was made to communicate basic facts about AIDS etiology and prevention. This included information that needle sharing and unprotected sex could spread the human immunodeficiency virus (HIV) that causes AIDS, while bleaching needles and using condoms properly could reduce the risk of infection. A step-by-step diagram on how to bleach needles was provided. Posters, pamphlets, billboards, and out-reach workers were used to spread the word in inner-city neighbors, and coverage of the campaign was sought in the news media. Strategies incorporating practical and theory-based suggestions for future campaigns on IV drug use and AIDS are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Durable power of attorney for health care. Are we ready for it?

Health care professionals need to be well informed about advance directives for medical care in the event a patient becomes incapacitated. The Patient Self-Determination Act requires that all patients be advised of their options at the time of hospital admission. Hospitals and health care professionals will need to work together to plan for implementing this law. We surveyed 215 physicians, nurses, and social workers at a Veterans Affairs Medical Center about the California advance directive, the Durable Power of Attorney for Health Care. Attitudes were generally positive. All of the social workers had heard of the durable power of attorney directive, but 36% of physicians and nurses had never heard of it and an additional 20% had no experience with one. For respondents who had heard of the directive, the mean knowledge score was 6.35 of a possible 10 (5 predicted by chance). Respondents brought up the issue of durable power of attorney with patients before a crisis only 19% of the time and determined whether one had been signed for only 16% of older patients in hospital. The most commonly cited reasons for failure to discuss this with patients were lack of proper forms, pamphlets, or a place to refer a patient. Of those who had ever seen such a document in use, 42% were aware of a problem with it at some time. Whereas attitudes toward advance directives are positive, many physicians and nurses had little knowledge of the Durable Power of Attorney for Health Care and were poorly equipped to discuss it with patients. We encourage educating hospital staff to prepare for the enactment of the Patient Self-Determination Act. We also recommend that the concerns raised by professionals about the use of a durable power of attorney be addressed.

Advance Directives↗
PubMed1991

Informal sector shops and AIDS prevention. An exploratory social marketing investigation.

Shopkeepers at 88 informal sector shops in the black township of Khayelitsha were interviewed to explore whether such shops should be considered as venues for the dissemination of AIDS prevention information and condoms through social marketing programmes. The existence of a variety of media and interpersonal information sources on the premises, the presence of opinion leadership and the willingness of several owners to distribute posters and pamphlets and sell condoms suggests that such shops should be further investigated as avenues for AIDS prevention efforts. A relationship was found between the degree to which a shop exhibited aspects of social influence and the degree to which it was established in terms of infrastructure, income and experience of personnel. It was concluded that shopkeepers might be an important group to target early in a programme, because they might then influence others' reaction to it. Finally, it would be important for shop personnel and other township residents to be part of the design, planning and implementation of AIDS prevention programmes.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Helmet promotion in the emergency room following a bicycle injury: a randomized trial.

Head injury is the leading cause of serious morbidity and mortality in bicycle accidents. There is good evidence to recommend helmets, yet few children wear them. Following a survey of children presenting to the emergency room with a bicycle injury, helmet promotion was evaluated in a randomized trial. The intervention consisted of physician counseling and take-home pamphlets. The study involved 334 children: 161 in the intervention group and 173 in the control group. In a follow-up telephone call, 2 to 3 weeks later, only 9.3% of the intervention group had purchased helmets, compared with 8.0% of the control group. Families in the intervention group received further counseling during the telephone contact, resulting in one additional purchase at 6-week follow-up. Evidence that a bike injury motivates cyclists to purchase helmets, and the influence of the self-administered questionnaire most likely account for the high purchase rate in the control group. Surprisingly, the helmet promotion intervention, including follow-up phone counseling, made no further impact. The results probably are best explained by a "double threshold" effect. Certain families were easily encouraged to buy a helmet, whereas others were far from ready to adapt this fairly recent innovation as routine cycling equipment. The findings suggest that physicians interested in helmet promotion would do better to participate in the design and implementation of multidisciplinary community campaigns.

Bicycling↗
PubMedDate not supplied

[Artificial feeding practice in nursery: a new policy and maternal response].

While a single-bottle method is what mothers actually do in preparation of infant formula in their own home, in the hospital, each nursery makes its own rules about preparing formula. Early in 1988 a "self-service", artificial feeding practice was initiated in this 600-bed general hospital. Mothers who intended to bottle-feed were asked to purchase the powdered formula at their own expense. At feeding time, mothers prepare one bottle of formula at a time, and feed the infant immediately. Each mother's technique of formula preparation was observed by the nurses, and practical instructions were given if needed. Particular errors and hazards in the reconstitution of formula were emphasized with posters hung on the nursery wall and by the pamphlets distributed to the mothers. These practices avoid distribution of formula samples at the hospital, and provide repeated practice for mothers during their hospitalization. To explore the attitudes of mothers toward this new feeding practice, a questionnaire survey of 483 consecutive mothers who gave birth to healthy newborns was carried out. While 61.3% of the mothers thought that it was acceptable to purchase infant formula themselves, 85.1% thought preparing the formula themselves in hospital was acceptable. Furthermore, only 1.2% of the mothers said that this new practice was a great deal of trouble. Most mothers said that on-the-spot teaching by nurses was very helpful. Regarding overall attitudes, 5.4% and 2.1%, respectively, will not or may not return for the next delivery. After controlling for several socio-educational variables, only previous experience with bottle-feeding was associated with pro-and-con responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Possibilities and limitations of public relations activities in the development of organized neighborhood assistance].

The article deals with the question how well known a new social service becomes which is completely based on voluntary and honorary work. The new service, organized neighbourhood help in Zürich-Altstetten, has been in existence since three years. To find out to what degree this new social service was known, a representative survey was carried out by telephone in which 208 persons living in the district referred to were interviewed one and a half years after the organized neighbourhood help had started working. --50% of the people living in the district Zürich-Altstetten were aware of the organized neighbourhood help, twice as many women than men knowing about it. The same relationship was observed between people who were fully occupied and people occupied in part-time jobs or not working: twice as many people of the latter group knew about this new social service. --About half of the people interviewed were interested in receiving more information about the service and 36% could even imagine participating in it. Although more information about the neighbourhood help was sent to these people, one year later still no one had applied. --The findings hint at a division of labour between the different channels of information: newspapers provide general information whereas pamphlets and recommendations from other social services are more likely to lead to registration.

Adult↗
PubMed1990

A randomized trial to improve self-management practices of adults with asthma.

The prevalence and impact of adult asthma are substantial, and poor self-management practices, especially failures to adhere to treatment regimens, appear to be a significant problem. Desirable characteristics of an intervention program to improve self-management were identified through needs assessment and review of existing patient education resources. A comprehensive program was developed that integrated a workbook with one-to-one counseling and adherence-enhancing strategies. A longitudinal 1-year study compared patients receiving this self-management program with "usual care" patients receiving standard asthma pamphlets. Patients were randomly assigned to conditions. Baseline score and asthma severity were statistically controlled. Self-management patients had substantially better adherence than usual care patients, as well as improved functional status, at follow-up. Hospital and emergency department visits decreased in both groups but did not differ between groups.

Adult↗
PubMed1990

Asthma and its management at a student health service.

Of 96 asthmatic students 62 said their asthma had not required them to give up any activity but only seven said it had not interfered in some way with their sport. Thirty-nine regarded their asthma as an annoyance and 13 of these were angered by it. Fifty-seven respondents took treatment continuously and the most favoured agent in attacks was salbutamol. Peak flow meters were not used regularly except by six students. About two-thirds had significant deficiencies in their knowledge of asthma and the most popular source of information was the general practitioner. Only 30 had read the Asthma Foundation pamphlets.

Activities of Daily Living↗
PubMed1990

[Melanoma screening in Debrecen].

Melanoma screening examination has been organized in Debrecen. The aid of it is the early detection and treatment of melanoma. Different methods (educational pamphlet, postgradual training of GP's, TV, radio) help the work of dermatologists.

Health Education↗
PubMed1990

Perceived credibility of channels and sources of AIDS information among Hispanics.

A total of 460 Hispanic adults were interviewed over the telephone regarding the credibility they assigned to various possible channels and sources of AIDS information. An AIDS hotline and printed information (e.g., books, pamphlets) were perceived as highly believable channels by significant proportions of the respondents. Individuals in closer contact with the disease (e.g., a physician, a counselor, a person with AIDS) were overwhelmingly perceived as the most credible sources of information. With the exception of the Surgeon General no other public figure was perceived to be highly credible by large proportions of the respondents. Although women tended to perceive the various channels and sources as highly credible in greater proportions than men, the rank ordering of the information channels and sources is the same for both genders. Credibility ratings were lowest for actors, singers, and sports figures as sources of AIDS information for Hispanics and for illustrated storybooks (fotonovelas) as a channel for the dissemination of information.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Breaking the smoking habit in general practice].

A total of 1,022 adult smokers were questioned about smoking habits and were submitted to pulmonary function tests with spirometry. These patients were subdivided into two groups depending on whether investigation of pulmonary function showed obstruction or normal findings. All of the patients were given the pamphlet: "Important information about smoking" published by the Danish Anticancer League and they were given standardized warnings about smoking and information about the result of the pulmonary function tests. Twelve months later, the patients were questioned about their current smoking habits. 9% with obstruction and 11% without obstruction, respectively, had stopped smoking.

Adolescent↗
PubMed1989

[Evaluation of information sources and the effectiveness of health education in the North Bohemian Region, as indicated by knowledge of risk factors for cardiovascular diseases].

In May 1988 in the North Bohemian region an anonymous enquiry was made among a representative group of 3,767 respondents which was focused among others on problems of health education. The respondents consider the most important source of health education in 60.37% a talk with their doctor, in 37.67% television and in 17.67% lectures. Newspaper articles, pamphlets and films are rated roughly equally (cca 5% of the respondents). Posters are negligible as a source of health education. Health education is most appreciated by the oldest age group and least by respondents aged 16-30 years. It is necessary to prefer the most appreciated forms of health education and to seek contents and forms attractive for the youngest group of patients. Part of the enquiry was focused on knowledge of risk factors of cardiovascular diseases. Smoking is considered generally most harmful, less than half know about the harmfulness of stress, few respondents know that diabetes is a risk factor (26.3%). The most frequently incorrectly mentioned factor was alcohol.

Adult↗
PubMed1989

Health promotion and prevention.

Techniques of promotive and preventive health care include: The use of proactive skills in the consultation; and the co-ordinated use of posters and pamphlets with media campaigns. An efficient medical record and patient recall system; and a doctor initiated health check programme with selected patients. A cost effective method of informing practitioners includes: Ensuring access to continuing medical education by supporting FMP and post-graduate medical institutes. The provision of educational material for both the patient and doctor combined with media publicity campaigns. Supporting RACGP CHECKUP and library services for isolated practitioners. Suggested changes to undergraduate medical education are: Promotive and preventive health care delivery needs to be an inbuilt part of the curriculum. Promotive and preventive health care needs to be taught by both academic and private general practitioners who have received tutor training. It should be presented in tutorial form and during student attachment at surgeries. It needs to be followed up by continuing education by postgraduate institutes, the RACGP and FMP. Government input required includes: The provision of increased academic resources and continued funding of FMP. Remuneration for general practitioners who are involved in undergraduate teaching. Alteration of the fee structure to reward quality of care. Allowing Medicare rebate for promotive and preventive health care delivery.

Health Promotion↗
PubMedDate not supplied

Communicating AIDS information to Hispanics: the importance of language and media preference.

Though Hispanics are the fastest-growing minority group in the United States and have a high cumulative incidence of acquired immunodeficiency syndrome (AIDS), very little data are available concerning attitudes and beliefs concerning AIDS in this population. In January 1988, 216 Hispanics from three clinics in Oregon participated in a survey regarding AIDS information acquisition and knowledge. Overall, respondents reported receiving more information about AIDS from broadcast media such as television (42.6%) and radio (19.9%) and less from print media such as newspapers (18.5%) and pamphlets (17.6%). Respondents whose primary language was Spanish tended to have fewer information sources and relied relatively more on broadcast media than on print media. Though over 90% of the sample believed AIDS could be transmitted sexually, only 50% thought condoms could prevent transmission. Compared to primarily English speakers, respondents whose primary language was Spanish were more likely to believe that AIDS could be casually transmitted and less likely to believe that condoms could prevent transmission. This study suggests that more information delivered in an effective manner, both culturally and linguistically, is needed.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Pediatric burn prevention: an evaluation of the efficacy of a strategy to reduce tap water temperature in a population at risk for scalds.

The efficacy of a strategy to prevent tap water scalds was evaluated in a population at risk. Educational pamphlets and liquid crystal thermometers for testing water temperature were distributed to 12 families, each of which had at least one child under the age of 3 and one child over the age of 3. Participants were visited individually by an investigator who monitored tap water temperature in a standardized manner and personally provided the educational material. No statistically significant decrease in hot water temperature occurred as a result of the intervention. The number of heaters operating at a safe temperature was not statistically different pre- and postintervention. Whether participants altered their thermostat settings or not, there was a tendency to maintain postintervention settings at 1-month follow-up. Capitalizing on this tendency by installing heaters at preset safe temperatures was discussed, as were changes in heater design and areas for additional research.

Accidents, Home↗
PubMedDate not supplied

Nursing habits and dental decay in infants: "nursing bottle caries".

The decay-producing capabilities of certain foods can be influenced by eating habits. When a habit of frequent nocturnal bottle or breast feeding is maintained beyond a year of age, the potential for gross dental decay in very young children is established. Bovine milk, milk formulas and human breast milk have all been implicated in the condition of "nursing bottle caries," because of their lactose content. Additional sweeteners in the nursing bottle, the use of fruit juices or the use of honey-dipped pacifiers can also cause "nursing bottle caries." "Nursing bottle caries" can be prevented through a timely educational program to new parents. Prevention is particularly applicable in young children, since a healthy oral condition promotes good nutrition, a healthy state and normal growth. Both the American Dental Association and the American Society of Dentistry for Children have pamphlets explaining "nursing bottle caries," which are available for distribution to the public.

Animals↗
PubMed1987

[The history of congenital malformations with special reference to conjoined twins. 1. From ancient times to the 18th century].

Congenital malformations are mentioned in Assyrian and Babylonian literature, and the opinions of Democritus, Empedocles and Aristotle regarding their origin persisted in modified form until the Middle Ages. Following the invention of printing, illustrations of congenital malformations began to appear on pamphlets. Although not always realistic, these illustrations provide a rich source of information regarding the spirit of those times. The first monographs containing collections and interpretations of malformations appeared in the 16th century. These were followed in the 17th century by increasingly realistic illustrations, and superstitious ideas regarding the causes of malformations, although still predominating, gradually started to recede.

Congenital Abnormalities↗