Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Pretesting”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources
PubMed1995

Analysis of an international emergency medical service train-the-trainer program.

STUDY OBJECTIVE: To assess the effectiveness of an international emergency medical services (EMS) train-the-trainer program. PARTICIPANTS: Seven bilingual Polish physicians attended a 350-hour US-based EMS training program. The physicians returned to Poland to train Polish-speaking EMS personnel. INTERVENTIONS: The Polish training was assessed by means of a pretest, a final examination, a series of skill stations, and a retrospective self-assessment instrument created by the authors. The retrospective self-assessment instrument, using a six-point Likert scale, measured the degree of self-reported competence before and after training in three areas: basic trauma, advanced medical, and basic medical. RESULTS: One hundred seventy-nine Polish students were assessed. Pretest scores ranged from 17% to 100% (mean, 74% +/- 11%). Ninety-one percent passed the final examination (mean, 91% +/- 4.0%; range, 74% to 99%). All students passed all skill stations. The before-and-after instrument indicated that the Polish students' prior competence ranged from not competent (Likert score 1) to fully competent (Likert score 6). Mean scores were: basic trauma, 2.6 +/- 4; advanced medical, 2.5 +/- 7; and basic medical, 2.8 +/- 7. After-course scores demonstrated improved competence. Before-and-after instrument score differences were significant for each area (P < .0001). CONCLUSION: Despite differences in language, culture, technology, and resources, an international train-the-trainer program can be evaluated. In addition to standard testing, a retrospective before-and-after self-assessment instrument provides corroborative evidence of program success.

Clinical Competence↗
PubMed1998

A multicenter study to improve emergency medicine residents' recognition of intracranial emergencies on computed tomography.

STUDY OBJECTIVE: Cranial computed tomography (CT) has assumed a critical role in the practice of emergency medicine for the evaluation of intracranial emergencies. Several recent studies have documented a deficiency in the emergency physician's ability to interpret these studies. The purpose of this study was to quantify the baseline ability of emergency medicine residents to interpret cranial CTs, and to test a novel method of cranial CT interpretation designed for the emergency physician in training. METHODS: A standardized pretest was administered to assess baseline ability to interpret CT scans. A standardized posttest was given 3 months after the course. Each test consisted of 12 CT scans with a short accompanying history. All scans were validated by 3 expert reviewers for difficulty and diagnosis. A 2-hour course based on the mnemonic "Blood Can Be Very Bad" was then administered. "Blood" reminds the examiner to search for blood, "Can" prompts the examiner to identify 4 key cisterns, "Be" denotes the need to examine the brain, "Very" prompts a review of the 4 ventricles, and finally "Bad" reminds the examiner to evaluate the bones of the cranium. RESULTS: Eighty-three residents at 5 institutions were initially examined. The mean percentage correct before the course was 60% (95% confidence interval [CI] 58%-64%) on the standardized pretest. At retesting 3 months after the course, the accuracy rate increased to 78% (n=61, 95% CI 75%-81%, P<.001 paired t test). CONCLUSION: Emergency medicine residents are deficient in their ability to interpret cranial CT scans. A novel educational course was demonstrated to significantly improve this ability.

Adolescent↗
PubMed1998

Intervention for medical students: effective infection control.

Needlestick injuries, which lead to the transmission of hepatitis B, hepatitis C, and the AIDS virus, are a potentially serious threat to students during their clinical experiences. Exposure to infectious diseases, blood, and hazardous body fluids is one of the most frequently reported injury events by medical students at a health science center in the southwestern region of the United States. This study was conducted to determine the effectiveness of a customized intervention about infection control for second-year medical students (N = 200). Preparation for the intervention included a needs assessment, which included both qualitative and quantitative research methods that incorporated input from fourth-year medical students, medical staff members, and local hospital infection control specialists. The intervention included a pretest, a lecture, a demonstration of standard precautions and infection control procedure with 2 clinical scenarios, an exercise on proper handwashing, and a posttest. The evaluation of the intervention demonstrated a significant increase in posttest knowledge scores about infection control (from 12.6 +/- 2.1 pretest to 16.5 +/- 1.8 posttest, P < .001). Medical students showed a significant knowledge increase about infection control after participating in the intervention . Thus we recommend that all medical colleges and universities develop and evaluate a similar customized intervention for their medical students.

Adult↗
PubMed1997

A pain education program for chronic cancer pain patients: follow-up results from a randomized controlled trial.

The effectiveness of a Pain Education Program in cancer patients with chronic pain offered by nurses was investigated in a randomized controlled clinical trial. A multi-method approach was used in which verbal instruction, written material, an audio cassette tape, and the use of a pain diary were combined to inform and instruct patients about pain and pain management. The Pain Education Program was tailored to the needs of the individual patient and consisted of three elements: (1) educating patients about the basic principles regarding pain and pain management; (2) instructing patients how to report their pain in a pain diary; and (3) instructing patients how to communicate about pain and how to contact health care providers. Following pretesting in 313 patients, patients who needed district nursing and who did not need district nursing at home were randomly assigned to a control or intervention group. Intervention group patients received the Pain Education Program in the hospital, and 3 and 7 days postdischarge by telephone; this was done by nurses who were specially trained as pain counselors. Follow-up assessments were at 2, 4 and 8 weeks postdischarge. Results of the pretest showed that many patients lacked knowledge about pain and pain management. The majority of pain topics had to be discussed. The Pain Education Program proved to be feasible: 75.0% of the patients had read the entire pain brochure, 55.7% had listened to the audio cassette, and 85.6% of pain scores were completed in the pain diary. Results showed a significant increase in pain knowledge in patients who received the Pain Education Program and a significant decrease in pain intensity. However, pain relief was mainly found in the intervention group patients without district nursing. It can be concluded that the tailored Pain Education Program is effective for cancer patients in chronic pain. The use of the Pain Education Program by nurses should be seriously considered on oncology units.

Chronic Disease↗
PubMed1999

Dynamic adjustments of walking behavior dependent on noxious input in experimental low back pain.

The aim of this study was to explore whether accelerations of the lower back during walking are temporarily attenuated by experimentally-induced low back pain, as compared with normal walking. Transient low back pain was induced by injection of 1 ml 6% hypertonic saline in the longissimus dorsi muscle in 20 healthy subjects. Acceleration was measured during walking at self-selected speeds before and repeatedly after the injection by a portable, triaxial accelerometer positioned over the L3 region. Data were subsequently adjusted for differences in walking speeds between trials and subjects. Pain was reported on a 0-10 point scale during walking until pain was no longer present. Lumbar acceleration sample mean was attenuated for the anteroposterior (P=0.002) and mediolateral (P=0.002) sensing axes as well as for the vector sum (P=0.005) at maximal pain compared to pretest values. The vertical axis showed no significant changes. Values returned to pretest level when pain was no longer present. Regardless of the initial increase and subsequent decrease in pain after injection, there was a linear relationship between pain and acceleration in 15 of the 20 subjects (0.89>/=R(2)>/=0.36, P</=0.002), suggesting a continuous dynamic adjustment of motor behavior dependent on the noxious input. It appears that this new method is suitable for detection of continuous subconscious changes of body accelerations during walking in relation to pain.

Acceleration↗
PubMed2000

Participation of hippocampal metabotropic glutamate receptors, protein kinase A and mitogen-activated protein kinases in memory retrieval.

The ability to recall past events is a major determinant of survival strategies in all species and is of paramount importance in determining our uniqueness as individuals. In contrast to memory formation, the information about the molecular mechanisms of memory retrieval is surprisingly scarce and fragmentary. Here we show that pretest inhibition of the specific upstream activator of mitogen-activated protein kinase kinase, or of protein kinase A in the hippocampus, blocked retrieval of long-term memory for an inhibitory avoidance task, a hippocampal-dependent learning task. An activator of protein kinase A enhanced retrieval. Mitogen-activated protein kinase activation increased in the hippocampus during retrieval, while protein kinase A activity remained unchanged. Pretest intrahippocampal blockade of metabotropic glutamate receptors or alpha-amino-3-hydroxy-5-methyl-4-isoxazolone propionic acid/kainate receptors, but not N-methyl-D-aspartate receptors or calcium/calmodulin dependent-protein kinase II, impaired retrieval. Thus, recall of inhibitory avoidance activates mitogen-activated protein kinase, which is necessary, along with metabotropic glutamate receptors, alpha-amino-3-hydroxy-5-methyl-4-isoxazolone propionic acid/kainate receptors, and protein kinase A, for long-term memory expression. Our results indicate that memory formation and retrieval may share some molecular mechanisms in the hippocampus.

Animals↗
PubMedDate not supplied

Preventing underage drinking: a "roll of the dice".

This study examines the efficacy of a video entitled "Underage Drinking: A Roll of the Dice," and accompanying discussion guide. The video illustrates the civil and criminal consequences of underage drinking. The video and discussion aimed to: (1) increase awareness about the problem of underage drinking; (2) increase viewers' and participants' knowledge and perceptions of the risks and responsibilities and reduce the perceived acceptability of underage drinking; and (3) encourage discussion between youths and adults about underage drinking. The "Roll of the Dice" was evaluated in 19 school and community groups in Hawaii. Groups were randomly assigned to receive follow-up materials or no follow-up materials. Evaluation involved three surveys: pretest, posttest, and follow-up. Three hundred youths and adults responded to the first two surveys, and 220 people completed a third survey. Youths and adults showed increases in short-term knowledge, perceived risk, and perceived responsibility, and a decrease in perceived acceptability of underage drinking after viewing the video. Significant improvement between the pretest and follow-up was observed, although the changes were not entirely maintained at the time of the posttest. The results showed that legal consequences of underage drinking are not common knowledge, and that a well-designed one-time program can make a difference. This video and discussion session provide an inexpensive way to raise adults' and youths' awareness of the laws and penalties, resulting in effects maintained for at least a month after the program. Additional follow-up materials did not enhance retention of changes in knowledge and attitudes.

Adolescent↗
PubMed2003

Evaluating the Lions-Quest "Skills for Adolescence" drug education program. Second-year behavior outcomes.

Thirty-four schools (n=7426 consented sixth graders, 71% of the eligible population) were randomized to conditions to test the hypothesis that Skills for Adolescence (SFA), a widely used comprehensive life skills training curriculum with a dedicated drug education unit, is more effective than standard care in deterring and delaying substance use through middle school. Two-year posttest (1-year post-intervention) data were collected from 5691 eighth graders (77% of those who completed the sixth-grade survey and 87% of those who completed the seventh-grade survey). Lifetime and recent (last 30 days) use of five substances or combinations of substances was compared using mixed-model regression to control for school clustering. There were two significant treatment main effects at the end of the eighth grade: lifetime (P=.05) and recent (P<.03) marijuana use were lower in SFA than control schools with pretest usage and salient demographic and psychosocial variables controlled. There was also one significant Treatment x Pretest Usage interaction around binge drinking. Baseline binge drinkers in SFA schools were less likely to report recent binge drinking than students in control schools (P<.01); there were no treatment differences among baseline nonbinge drinkers. Analyses of potential mediators of SFA treatment effects on eighth-grade binge drinking and marijuana use suggested that SFA increased self-efficacy around drug refusal skills, but did not affect behavioral intentions, perceptions of harm, or perceived peer norms. These 2-year (1-year post-intervention) outcomes offer some additional support for SFA effectiveness and the general thrust of school-based, life skills-based prevention programs. The promising sixth- through eighth-grade findings for SFA, a commercially available program, provide a further step in bridging a major gap in the "research to practice" literature: theory-based interventions that have documented behavioral effects have not enjoyed large-scale implementation, while intuition-based programs that have no documented effects still enjoy wide exposure.

Adolescent↗
PubMed2000

Selective activity of Streblus asper on Mutans streptococci.

The purpose of this in vivo one group time series design and single blind study was to determine the antimicrobial effectiveness of a mouthrinse containing Streblus asper leaf extract on Streptococcus mutans and total salivary bacteria following single 60 s rinse. Changing in salivary pH and buffer capacity during the experimental period were also measured. Thirty human subjects participated in this study. At each experimental session, a pretest saliva sample was taken. After giving the pretest samples, the subjects rinsed with S. asper leaf extract or distilled water control for 60 s, then the post-test saliva samples were collected at 0, 0.5, 1, 3, 5 and 6 h. The samples were used to determine the numbers of S. mutans and total salivary bacteria. The results indicated that S. asper leaf extract significantly reduced S. mutans counts compared with distilled water. However, the mean difference from baseline of total salivary bacterial counts was not significantly different between rinsing with S. asper leaf extract and distilled water. Moreover, S. asper leaf extract showed no effects in modifying the salivary pH and buffer capacity. It is concluded that of mouthrinse containing S. asper leaf extract can reduce S. mutans without changing an oral ecology.

Adolescent↗
PubMed2001

Stress testing for risk stratification of patients with low to moderate probability of acute cardiac ischemia.

In summary, this article focused on the use of stress testing to risk-stratify patients at the conclusion of their emergency evaluation for ACI. As discussed, those patients in the probably not ACI category require additional risk stratification prior to discharge. It should be kept in mind that patients in this category are heterogeneous, containing subgroups at both higher and lower risk of ACI and cardiac events. The patients with lower pretest probability for ACI may only need exercise testing in the ED. Patients with higher pretest probability should undergo myocardial perfusion or echocardiographic stress testing to maximize diagnostic and prognostic information. Prognostic information is the key to provocative testing in the ED. Prognostic information is the component that will help emergency physicians identify the patients who may be discharged home safely without having to worry about a 6% annual cardiac death rate and a 10% overall death rate over the next 30 months. Stress testing provides this key prognostic data, and it can be obtained in short-stay chest pain observation units in a safe, timely, and cost-effective fashion.

Acute Disease↗
PubMed2002

Low event rate for stress-only perfusion imaging in patients evaluated for chest pain.

OBJECTIVES: We sought to demonstrate the safety of stress-only perfusion imaging among patients with low to medium probability of coronary disease being evaluated for chest pain. BACKGROUND: The need for performing rest in addition to stress perfusion imaging to confirm normalcy is due largely to defects created on the stress images by attenuation artifacts. A low cardiac event rate among patients undergoing stress-only imaging with attenuation correction (AC) would validate the safety of stress-only imaging. METHODS: Patients with low to medium pretest probability for coronary artery disease (CAD) referred for chest pain evaluation from July 1, 1997 to July 1, 1999, were scheduled for a two-day stress/rest tomographic (single photon emission computerized tomography, or SPECT) perfusion imaging study with Tc-99m sestamibi. Patients were imaged on a variable angle camera with AC using Gd-153 scanning line sources (Vantage ADAC, Milpitas, California). If the stress scan was normal without AC or corrected with AC, the patient did not return for rest scan and was followed. RESULTS: Seven hundred twenty-nine patients underwent stress-only imaging, and follow-up was obtained on 652 (89%) of those patients. There were 224 males and 428 females with mean age of 52 +/- 13 years. Mean follow-up was 22.3 +/- 6.4 months. The mean pretest probability was 37 +/- 24%. The non-AC images showed breast and/or diaphragmatic attenuation artifacts severe enough to have required the patient to return for rest imaging in 37% of patients, and all corrected completely with AC. During follow-up, there were two noncardiac deaths and no cardiac deaths. There was one myocardial infarction; three patients with progressive unstable angina underwent diagnostic coronary angiography showing significant CAD. The overall cardiac event rate was 0.6%. CONCLUSIONS: These results support stress-only imaging in patients with low to medium probability for CAD as a safe, time- and cost-efficient imaging modality.

Adult↗
PubMed1997

Value of gating of technetium-99m sestamibi single-photon emission computed tomographic imaging.

OBJECTIVES: The purpose of this study was to determine how frequently and for what reasons the addition of electrocardiographically gated technetium-99m (Tc-99m) sestamibi single-photon emission computed tomographic (SPECT) images add value to nongated SPECT perfusion images. BACKGROUND: Electrocardiographic gating of Tc-99m sestamibi SPECT images permits assessment of regional and global left ventricular function and may assist in differentiating attenuation artifacts from myocardial scar. METHODS: A total of 285 consecutive patients (143 women and 142 men; mean age 57.6 +/- 11.5 years) underwent gated SPECT Tc-99m sestamibi imaging (212 with exercise, 63 with dipyridamole and 10 with dobutamine). The conventional stress and rest tomograms were interpreted first by means of a 14-segment scoring system, and then the studies were reinterpreted while the gated images were viewed. RESULTS: In the total group of 285 patients, the number of "borderline" interpretations was reduced from 89 to 29. In the 137 patients with a < or = 10% pretest likelihood of coronary artery disease, the addition of gated images added significantly to the percentage of interpretations that were designated "normal" (74% [101 of 137] vs. 93% [127 of 137], p < 0.0001), due to a reduction in borderline normal and borderline abnormal readings. In 49 patients with a previous infarction or recent angiography with > or = 70% stenosis, or both, the addition of gated images changed the percentage of "abnormal" scan interpretations from 78% (38 of 49) to 92% (45 of 49). This result was not significant (p = 0.09, two-tailed), but the trend was toward a greater number of unequivocal abnormal interpretations in this subgroup. CONCLUSIONS: The addition of electrocardiographically gated Tc-99m sestamibi SPECT images to the reading of stress and rest perfusion images alone resulted in shifting the final scan interpretations to a more normal designation in patients with a low pretest likelihood of coronary artery disease, and to more abnormal defects consistent with coronary artery disease in patients with known coronary artery disease. The number of "borderline normal" and "borderline abnormal" interpretations are significantly reduced when gated SPECT images are interpreted simultaneously with stress and rest perfusion images.

Coronary Disease↗
PubMed1998

Outcome after normal exercise echocardiography and predictors of subsequent cardiac events: follow-up of 1,325 patients.

OBJECTIVES: This study sought to examine the outcome of a large group of patients after normal exercise echocardiography and to identify potential predictors of subsequent cardiac events. BACKGROUND: Earlier studies suggested that prognosis after normal exercise echocardiography is favorable, with a low subsequent cardiac event rate. These studies involved a small number of patients and did not have sufficient statistical power to stratify risk. METHODS: The outcomes of 1,325 patients who had normal exercise echocardiograms were examined. End points were overall and cardiac event-free survival. Cardiac events were defined as cardiac death, nonfatal myocardial infarction and coronary revascularization. Patient characteristics were analyzed in relation to time to first cardiac event in a univariate and multivariate manner to determine which, if any, were associated with an increased hazard of subsequent cardiac events. RESULTS: Overall survival of the study group was significantly better than that of an age- and gender-matched group obtained from life tables (p < 0.0001). The cardiac event-free survival rates at 1, 2 and 3 years were 99.2%, 97.8% and 97.4%, respectively. The cardiac event rate per person-year of follow-up was 0.9%. Subgroups with an intermediate or high pretest probability of having coronary artery disease also had low cardiac event rates. Multivariate predictors of subsequent cardiac events were angina during treadmill exercise testing (risk ratio [RR] 4.1, 95% confidence interval [CI] 1.5 to 11.0), low work load (defined as < 7 metabolic equivalents [METs] for men and < 5 METs for women; RR 3.2, 95% CI 1.4 to 7.6), echocardiographic left ventricular hypertrophy (RR 2.6, 95% CI 1.1 to 6.3) and advancing age (RR 1.04/year, 95% CI 1.0 to 1.1). CONCLUSIONS: The outcome after normal exercise echocardiography is excellent. Subgroups with an intermediate or high pretest probability of having coronary artery disease also have a favorable prognosis after a normal exercise echocardiogram. Characteristics predictive of subsequent cardiac events (i.e., patient age, work load, angina during exercise testing and echocardiographic left ventricular hypertrophy) should be considered in the clinical interpretation of a normal exercise echocardiogram.

Aged↗
PubMed1999

An algorithm for noninvasive identification of angiographic three-vessel and/or left main coronary artery disease in symptomatic patients on the basis of cardiac risk and electron-beam computed tomographic calcium scores.

OBJECTIVES: We sought to model an algorithm for noninvasive identification of angiographically obstructive three-vessel and/or left main disease based on conventional cardiac risk assessment and site and extent of coronary calcium determined by electron-beam computed tomography (EBCT). BACKGROUND: Such an algorithm would greatly facilitate clinical triage in symptomatic patients with no previous diagnosis of coronary artery disease (CAD). METHODS: We examined 291 patients with suspected, but not previously diagnosed, CAD who underwent coronary angiography for clinical indications. Cardiac risk factors were determined as defined by the National Cholesterol Education Program. An EBCT scan was performed in all patients, and a coronary calcium score (Agatston method) was computed. Total per-patient calcium scores and separate scores for the major coronary arteries were generated. These scores were also analyzed for localization of coronary calcium in the more distal versus proximal tomographic sections. These parameters and the risk factors were considered for the model described in the following section. RESULTS: Sixty-eight patients (23%) had angiographic three-vessel and/or left main CAD. Multiple logistic regression analysis determined male sex, presence of diabetes and left anterior descending (LAD) and circumflex (LCx) coronary calcium scores, independent from more distal calcium localization, as independent predictors for identification of three-vessel and/or left main CAD. Based on this four variable model, a simple noninvasive index (NI) was constructed as the following: loge(LAD score) + log(e)(LCx score) + 2[if diabetic] + 3[if male]. Receiver operating characteristic curve analysis for this NI yielded an area under the curve of 0.88+/-0.03 (p < 0.0001) for separating patients with, versus without, angiographic three-vessel and/or left main CAD. Various NI cutpoints demonstrated sensitivities from 87-97% and specificities from 46-74%. The NI values >14 increased the probability of angiographic three-vessel and/or left main CAD from 23% (pretest) to 65-100% (posttest), and NI values <10 increased the probability of no three-vessel and/or left main CAD from 77% (pretest) to 95-100% (posttest). CONCLUSIONS: On the basis of a simple algorithm ("noninvasive index"), EBCT calcium scanning in conjunction with risk factor analysis can rule in or rule out angiographically severe disease, i.e., three-vessel and/or left main CAD, in symptomatic patients.

Algorithms↗
PubMed1999

The economic consequences of available diagnostic and prognostic strategies for the evaluation of stable angina patients: an observational assessment of the value of precatheterization ischemia. Economics of Noninvasive Diagnosis (END) Multicenter Study Group.

OBJECTIVES: The study aim was to determine observational differences in costs of care by the coronary disease diagnostic test modality. BACKGROUND: A number of diagnostic strategies are available with few data to compare the cost implications of the initial test choice. METHODS: We prospectively enrolled 11,372 consecutive stable angina patients who were referred for stress myocardial perfusion tomography or cardiac catheterization. Stress imaging patients were matched by their pretest clinical risk of coronary disease to a series of patients referred to cardiac catheterization. Composite 3-year costs of care were compared for two patients management strategies: 1) direct cardiac catheterization (aggressive) and 2) initial stress myocardial perfusion tomography and selective catheterization of high risk patients (conservative). Analysis of variance techniques were used to compare costs, adjusting for treatment propensity and pretest risk. RESULTS: Observational comparisons of aggressive as compared with conservative testing strategies reveal that costs of care were higher for direct cardiac catheterization in all clinical risk subsets (range: $2,878 to $4,579), as compared with stress myocardial perfusion imaging plus selective catheterization (range: $2,387 to $3,010, p < 0.0001). Coronary revascularization rates were higher for low, intermediate and high risk direct catheterization patients as compared with the initial stress perfusion imaging cohort (13% to 50%, p < 0.0001); cardiac death or myocardial infarction rates were similar (p > 0.20). CONCLUSIONS: Observational assessments reveal that stable chest pain patients who undergo a more aggressive diagnostic strategy have higher diagnostic costs and greater rates of intervention and follow-up costs. Cost differences may reflect a diminished necessity for resource consumption for patients with normal test results.

Angina Pectoris↗
PubMedDate not supplied

A study of visualization and addiction treatment.

Using a quasiexperimental design, in an intensive outpatient chemical dependency treatment program, this research compared a psychoeducational addiction treatment group with an intervention that combined progressive relaxation and visualization in a group setting. The progressive relaxation and visualization treatment consisted of six hour-long sessions that replaced psychoeducation treatment groups over the space of a 3-week period. The visualization group and the psychoeducation treatment groups were compared via pretest and posttest instruments to examine the impact of treatments on levels of emotional arousal, self-efficacy, and coping resources. The State-Trait Anxiety Inventory (STAI), the Situational Confidence Questionnaire (SCQ), and the Coping Resources Inventory (CRI) were used as part of the standardized measures. A total of 76 participants were involved in this study, which was conducted over an 8-month period. (As they entered treatment, participants were assigned to groups in a fashion that would maintain equivalency of group size.) Statistical tests determined that the nonrandomly assigned treatment groups were not significantly different from each other at the outset of the treatment interventions, t-tests and multivariate analysis of variance and covariance (MANOVA/MANCOVA) were used to examine the results of the study. The t-tests revealed that there were significant pretest/posttest differences (p < .05) for both groups on almost all the dependent measures. MANCOVA, using pretest levels of the dependent measures as the covariate, did not reveal significant differences between the two groups (i.e., both groups showed equal levels of improvement on the posttest measures). Also, there were outcome differences for individuals who achieved greater degrees of relaxation and increased involvement in visualization session. In conclusion, both psychoeducation and visualization treatments were equally effective in producing positive effects. Although there is little empirical research that evaluates the effectiveness of psychoeducation treatment provided by chemical dependency treatment programs, these findings support that psychoeducation treatment is producing positive treatment effects. Further research is needed to assess the incremental benefit of using visualization as an adjunct to psychoeducation treatment.

Adult↗
PubMed2000

A pain monitoring program for nurses: effects on nurses' pain knowledge and attitude.

One of the reasons for inadequate pain treatment in hospitalized patients is that nurses have insufficient knowledge about pain and pain management. To address this problem, a Pain Monitoring Program (PMP) for nurses was developed, implemented, and evaluated. The PMP consisted of two components: educating nurses about pain, pain assessment, and pain management, and implementing daily pain assessment by means of a numeric rating scale. The effects of the PMP were measured in a one-group pretest-post-test design. The results show that nurses have knowledge deficits and prejudices with regard to pain and pain management. Age and additional pain courses in pain partly predict nurses' pain knowledge. After nurses were educated, the average score on the Pain Knowledge Questionnaire increased from 69.1% (SD = 13.2) at pretest to 75.8% (SD = 11.5) at post-test (P < 0.001). Nurses' attitudes changed with regard to their level of knowledge and skills in relieving pain, willingness to assess pain on a daily basis, and attention to patients' pain complaints. It can be concluded that the PMP is effective in improving nurses' knowledge of pain management and focusing nurses' attention to patients' pain complaints.

Adult↗
PubMed2000

How response shift may affect the measurement of change in fatigue.

If patients experience extreme fatigue during treatment, they may judge the level of fatigue following this experience differently from how they would have judged it before. This change in internal standard is referred to as a response shift. We explored whether a response shift might have occurred in patients receiving radiotherapy (n = 199). Fatigue was assessed before and after radiotherapy. Following completion of the post-test, a thentest was administered where patients had to provide a renewed judgment of their pre-treatment level of fatigue. Response shift was assessed by the mean difference between the pre-test and thentest scores. Comparing the thentest with the pretest scores, patients retrospectively minimized their pre-treatment level of fatigue. The thentest-post-test difference was significant, whereas the conventional pretest-post-test difference was not. These results are in line with the occurrence of a response shift. Additional hypotheses regarding response shift were partially supported. It is concluded that the potentially large implications of response shift justify further research.

Fatigue↗