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At least 973 records · Page 54Linked to original sources
PubMed2001

Does functional ability in the postoperative period differ between remifentanil- and fentanyl-based anesthesia?

STUDY OBJECTIVES: To compare patients' functional ability in the 24-hour postoperative period following a remifentanil compared to a hypnotic-fentanyl-treated anesthesia regimen using a 24-Hour Functional Ability Questionnaire. DESIGN: Prospective, 1:1 single-blind, randomized, controlled effectiveness study. SETTING: Multicenter study including 156 hospitals and ambulatory surgery facilities. PATIENTS: 2438 patients (1496 outpatients and 942 inpatients) 18 years of age or older, scheduled for elective surgeries under general endotracheal anesthesia, with an expected duration of unconsciousness of > or =30 minutes. INTERVENTIONS: Patients were randomized to receive either intravenous remifentanil (0.5 microg/kg/min for induction and intubation; with the infusion rate decreased to 0.25 microg/kg/min after intubation) or fentanyl (administered according to anesthesiologists' usual practice) as the opioid during surgery. Concomitant hypnotic drugs were propofol and/or isoflurane (with or without nitrous oxide) titrated according to protocol. Transition analgesia with either morphine or fentanyl was given in the remifentanil patients and at the discretion of the anesthesiologists in the fentanyl patients. MEASUREMENTS: A validated set of measurements of functional ability, rather than more traditional clinical psychological methods, to compare the recovery of patients from remifentanil- and fentanyl-treated anesthetic regimens up to 24 hours after surgery. MAIN RESULTS: Remifentanil was statistically superior to fentanyl for the four functional assessments evaluated: walking without dizziness, thinking clearly, concentration, and communicating effectively. These differences reflect events occurring within the first 24 hours after anesthesia and surgery. CONCLUSIONS: A remifentanil-treated anesthetic demonstrated earlier return to some functions than a fentanyl-treated technique. Although functional assessment is a field that is still in its infancy, a questionnaire to assess functional ability during the 24 hours after anesthesia may provide more practical information about anesthetic recovery than previously used, traditional psychomotor evaluations.

Analgesics, Opioid↗
PubMed1991

Antibiotic residue prevention methods, farm management, and occurrence of antibiotic residues in milk.

The objective of this study was to determine associations among the occurrence of antibiotic residues in bulk milk and various farm management practices. Ninety-four dairy farms were visited after antibiotic residues were detected in samples of their bulk milk (case farms) along with an equal number of residue-free farms (controls). Farmers completed questionnaires designed to elicit details of management practices used on farms and methods employed for prevention of antibiotic residues. Factors were initially examined unconditionally for statistical association with occurrence of residues; then multivariate associations were determined using multiple logistic regression. After adjusting for herd size in a logistic model, the risk of residues in milk was observed to increase in association with the frequent use of part-time labor in the milking of cows. The risk of residue occurrence was decreased in association with the use of milk residue test kits, when the farmer believed that increasing the dose of antibiotic required an increase in the withholding time of milk, and when tie stall and pipeline milking systems were used rather than milking parlors or tie stall and dumping station systems.

Animals↗
PubMed1991

[Psychological and social evaluation].

The purpose of psychological and social assessment of health programs is the measurement of psychological well-being and lifestyle in targeted populations (i.e. pregnant women, mothers, children or teenagers) and interactive effects on other family members. A psychological and social evaluation should contain the following elements: social and/or cultural factors that facilitate participation in a health program, the opinion of and satisfaction with the program, the psychological and social consequences of the program. Three types of tools can be utilized to measure psychological and social indicators: standardized questionnaires, questionnaires designed specifically for the study in question, and interviews. Study protocols, data collection and analyses must be done using the same methods as those used in any other type of medical evaluation. The investigator must be particularly sensitive to the quality of the measurement tools, the size of the sample and the effects of confounding factors. Social and psychological aspects are essential in the evaluation of a health program. On the one hand, they allow for an understanding of how a health program is accepted and applied within a population. On the other hand, they enable the verification of whether or not there has been any change in the quality of life among individuals and their families.

Adult↗
PubMed1985

Rape-related services in federally funded community mental health centers.

Amendments to the Community Mental Health Centers Act (Public Law 94-63) required community mental health centers (CMHCs) to provide such rape-related services as rape prevention and control, and to assure service availability to rape victims and their families. A questionnaire designed to assess how rape-related services are delivered was mailed to directors of 107 federally funded comprehensive CMHCs in a seven-state region. Fifty-five responses were received, indicating that rape-related services were offered by approximately two-thirds of the centers, 65% of which considered their rape-related services to be less comprehensive than other services. The budget for rape services was less than $10,000 in 80% of responding centers, representing less than 0.5% of the average CMHC budget. Services provided, primarily clinical, involved crisis intervention, counseling, and psychotherapy with rape victims and their families. Prevention and educational activities accounted for less than 25% of all rape-related services at most CMHCs. The results of the study question the impact of federal mandates on local mental health services.

Community Mental Health Centers↗
PubMed2005

Self-perception in children with attention deficit/hyperactivity disorder.

The purpose of this study was to compare self-perceptions of children diagnosed with attention deficit/hyperactivity disorder (ADHD) with those of children not diagnosed with ADHD. Seventy-seven children aged 8-12 years composed the two groups-38 participants with ADHD and 39 control participants without ADHD. The children completed the Self-Perception Profile for Children Questionnaire designed to measure self-perceptions in school-aged children. t Tests compared differences in mean scores between the groups. The ADHD group had a significantly lower overall score and a lower score on the behavioral conduct subscale compared with children without ADHD. Findings suggest a difference in the way school-aged children with ADHD perceive themselves as compared with their peers. The cumulative effect of years of low self-esteem and negative self-perception may have significant life consequences. Attention should be focused on fostering self-esteem and positive self-perception in children with ADHD through support groups and behavioral training.

Adaptation, Psychological↗
PubMed2000

Veterinary education and students' attitudes towards animal welfare.

Veterinary students at two British universities in their first preclinical, first clinical and final years of study, completed questionnaires designed to assess their attitudes towards the welfare of animals. These attitudes were divided into their two constituent components: emotional (emotional empathy with animals) and cognitive (belief in the sentience of animals). Analyses of variance revealed that the year of study was significantly related to the perceived sentience of dogs, cats and cows, with students in their later years of study rating them as having lower levels of sentience. The female students rated themselves as having significantly higher levels of emotional empathy with animals than did the male students. There was also a significant interaction between sex and year of study, the female students maintaining relatively high levels of empathy throughout the three years, whereas the male students showed lower levels of empathy in their later years.

Animal Welfare↗
PubMed2000

[Cancer in primary care in Vestfold in the year of 2000].

BACKGROUND: Developing high-quality patient-centred palliative care involving different professions in a local health care situation is a challenging task. It is difficult to establish co-operation on the allocation of resources to individual patients throughout the phases of disease. There are financial constraints, but also incongruities between the various levels of the health care system. Doctors' participation in cancer care is hidden in various tasks, and the contribution of GPs can be difficult to grasp. Patient-centred cancer care requires local co-operation; the intention in public health policy is to let the GP and the primary care nurse provide continuity of care, with the GP in the role of co-ordinator and organiser. MATERIAL AND METHODS: A postal questionnaire designed to survey GPs' own involvement in cancer care was sent to all 163 members of the Association of General Practitioners in Vestfold County, Norway. RESULTS: Out of 146 active members, 109 (75%) responded. GPs are regularly personally involved in the care of cancer patients; a majority of the GPs in Vestfold County have long experience. 72 respondents would take over controls as a shared responsibility and 80 are ready to follow up patients who want to live in their own homes until the end. Selv-evaluation of competence in pain control is good in a minority (13-40%). INTERPRETATION: There is a sizeable potential for quality improvement in local palliative cancer care and in the vertical and horizontal communication between the professional groups involved.

Attitude of Health Personnel↗
PubMed2006

Assessment of sexual functions after spinal cord injury in Indian patients.

This study assessed the interacting physical, psychological and social aspects of sexuality among 86 males and 14 females with spinal cord injury (SCI). Data collection involved the use of a 42-item study-specific questionnaire designed to determine different aspects of sexuality. Subjects were rated, after interview, on a scale according to an integrated index of sexual function (IISF). It was observed that patients scoring higher on this index were sexually more active and showed positive sexual adjustments. A higher incidence of complications of SCI, partner dissatisfaction, less partner co-operation, lower self-esteem and social taboos were factors responsible for less sexual activity in our patients. The present study suggests that there is a strong need for improved treatment of the medical complications of SCI, sexual counselling, literature, information and peer support in this country. We are of the opinion that the IISF can be utilized in rehabilitation settings to examine the interplay of the various complex factors in sexual rehabilitation post-SCI.

Adult↗
PubMed1997

Sexual dysfunction among type II diabetic men: a controlled study.

This was a primary health care (PHC) study aiming at the investigation of the prevalence and nature of sexual dysfunction among a sample of type II diabetic men, in comparison with the control groups of hypertensive men and apparently healthy men with no chronic medical illness. Subjects were assessed by PHC physicians using a sexual dysfunction semistructured questionnaire and a questionnaire designed for medical history and sociodemographic data. Clinical assessments for peripheral vascular disease and peripheral neuropathy were carried out for the diabetic group only. The estimated high prevalence rate of sexual dysfunction among the diabetic group (89.2%) was significantly greater than the hypertensive group (43.6%), and the apparently healthy group (16.7%). The commonest clinical presentations of sexual dysfunction among the diabetic men were impaired morning and spontaneous erections, erectile weakness, and ejaculatory disturbances. Lesser common presentations were reduced sexual interest and complete erectile failure. There were no significant associations between the sexual dysfunction and clinically obvious physical complications of diabetes, or factors that might affect sexual functioning (i.e., alcohol or drug misuse or marital disharmony). However, the validity of these results is questioned due to the small numbers used for statistical analysis.

Adult↗
PubMed2002

The International Outcome Inventory for Hearing Aids (IOI-HA): psychometric properties of the English version.

The International Outcome Inventory for Hearing Aids (IOI-HA) is a seven-item questionnaire designed to be generally applicable in evaluating the effectiveness of hearing aid treatments. The inventory was developed to facilitate cooperation among researchers and program evaluators in diverse settings. It is brief and general enough to be appended to other outcome measures that might be planned in a particular application, and will provide directly comparable data across otherwise incompatible projects. For this plan to be successful, it is essential to generate psychometrically equivalent translations in the languages in which hearing aid research and treatment assessments are performed. This article reports the psychometric properties of the inventory for the original English version. The items are reasonably internally consistent, providing adequate statistical support for summing the scores to generate a total outcome score. However, for maximum internal consistency, it would be desirable to generate two scores for the inventory.

Adult↗
PubMed2004

Neuropathic pain symptoms relative to overall pain rating.

UNLABELLED: The influence of sensory symptoms on overall simple pain ratings in neuropathic pain is not well understood. The goal of this study was to determine this relationship by using the Neuropathic Pain Questionnaire (NPQ) and Neuropathic Pain Scale (NPS) in patients who had neuropathic pain. Overall pain intensity ratings were assessed by means of Average and Worst Pain ratings from the Brief Pain Inventory. Ongoing average pain was rated as 5.7 and worst pain as 7.7 on 0 to 10 scale, and it was present in 96% of patients, whereas symptoms that are commonly studied in the laboratory, such as increased pain due to touch and due to heat, were much less frequent (64% and 38%, respectively). Worst pain was most highly correlated with shooting, stabbing, and distress symptom complex, which was in contrast to Average pain, which was most highly correlated with symptom complex consisting of a large number of items. Analysis of conceptually related thermal heat sensation types of pain, spontaneous "burning" pain and the evoked pain "increased due to heat," showed that spontaneous burning pain was reported at much higher frequency and intensity than the evoked increased pain due to heat. There was no statistically significant difference between descriptors from NPS and NPQ among subgroups of neuropathic pain, such as polyneuropathy, radiculopathy, or posttraumatic neuralgia, but this could be in part due to relatively small number of patients in these subgroups of neuropathic pain. Quantitative analysis, as performed in this study, is one of the steps in developing an approach for elucidating the relationship between neuropathic pain symptoms and underlying mechanisms. PERSPECTIVE: Assessment of neuropathic pain symptoms by means of specifically designed questionnaires provides significant insight into patients' pain experience, including pain overall, which is under many influences. Further research of this type can contribute to advances in mechanism-based diagnosis and treatment.

Adult↗
PubMed2002

Swedish forensic nursing care: nurses' professional contributions and educational needs.

Nurses (registered nurses, RN, and licensed mental nurses, LMN) working in five Swedish forensic psychiatric units filled in a questionnaire designed for general psychiatric nursing, but modified for forensic use. In this report, data regarding how nursing care could contribute to improved care and the organizational changes needed and what knowledge the nurses need, in order to be able to meet the demands in the future, were analysed by means of content analysis. The salient findings were: (i) an interpersonal patient-nurse relationship based on trust, empathy, respect and responsibility for the patients' personal resources and knowledge seems to be the essence of nursing care and a way to improve care; and (ii) the nurses' educational needs emanate from different treatment modalities, how to perform different treatments, how to establish developing relationships and in-service training adapted to the ward-specific problems.

Anecdotes as Topic↗
PubMed2003

Medical students' learning needs about setting and maintaining social and sexual boundaries: a report.

BACKGROUND: Despite increasing awareness of the potentially harmful consequences of social and sexual relationships between doctors and patients, little assessment has been made of the learning needs of medical students for setting and maintaining social and sexual boundaries in the doctor-patient relationship. AIM: To assess the learning needs of students with regard to issues concerning the setting of professional boundaries. METHODS: The study used a 4-part questionnaire, designed to collect both quantitative and qualitative data from medical students in all 6 years of the medical curriculum at 1 Australian university. RESULTS: A total of 293 students participated (94.5% response rate). The majority of students were ambivalent about the relationship between social and sexual boundary violations and sexual misconduct. A total of 21% of students said that sexual contact with patients might not be inappropriate. Short answers to a series of vignettes demonstrated conservatism on the part of students when faced with dilemmas. Most (87.4%) of the student population surveyed stated that insufficient teaching time had been given to issues concerning social and sexual boundaries. CONCLUSION: If medical schools shun teaching about the violation of social and sexual boundaries in doctor-patient relationships, sexual predators will continue to graduate.

Attitude of Health Personnel↗
PubMedDate not supplied

Is there an optimum number of night shifts? Relationship between sleep, health and well-being.

By concentrating on the impact of a specific shift-system feature on the well-being of those concerned, rather than on the impact of the shift system as a whole, one might be able to offer more meaningful suggestions as to what constitutes a better form of shift system. The present study focused on the impact of the number of consecutive night shifts worked on the health and well-being of two groups of nurses (permanent night and rotating shift). All nurses completed a copy of the Standard Shiftwork Index, which is a set of questionnaires designed for comparing the effects of different types of shift system on large groups of workers. It includes measurements of psychological ill-health, physical ill-health, chronic fatigue, social and domestic disruption, attitudes towards shiftwork, sleep quality and sleep habits. Results showed clearly the impact of the number of consecutive nights worked on health and well-being, not directly, but indirectly through the impact on sleep duration and sleep quality. Sleep duration was shown to increase with more consecutive nights worked. This in turn was found to predict sleep quality, which in turn was found to be the stronger direct predictor of psychological and physical ill-health i.e. better health was associated with longer and better quality sleeps. Explanations in terms of circadian adaptation are discussed.

Adaptation, Physiological↗
PubMed2005

Psychological distress among women suffering from couple infertility in South Africa: a quantitative assessment.

BACKGROUND: Infertility in Africa is commonly associated with negative psycho-social consequences. To date, most studies from African countries addressing these consequences have been qualitative in nature. The aim of this study was to assess psychological distress quantitatively among women suffering from couple infertility in an urban community in South Africa. METHODS: The Symptom Checklist-90-R (SCL-90-R), a standardized instrument for the measurement of current psychological symptom status, was administered to 120 women at the time of their first presentation to an infertility clinic in a tertiary referral centre. The control group comprised 120 women presenting to local family planning clinics. In addition, socio-demographic information and data pertaining to the prevalence of abuse was captured through a structured questionnaire designed for the purpose of this study. RESULTS: Women suffering from involuntary childlessness scored significantly higher on all sub-scales and the global indices of distress of the SCL-90-R when compared to controls. In addition, women who reported abuse from their male partners had significantly higher scores on six of the 12 test scales when compared to infertile women in non-abusive relationships. CONCLUSIONS: Involuntary childlessness is associated with high levels of psychological distress. Women in abusive relationships are particularly at risk. This result is in keeping with several qualitative studies from African countries which describe infertility as an overwhelmingly negative and distressing experience. Cognizance needs to be taken of these experiences and effective interventions require medical, psychological and socio-cultural strategies.

Adult↗
PubMed1995

[Transferred employees' psychological stress due to "tanshin-funin" family separation: a study of stress responses].

A transferred employee may take his family along (taido-funin), or have to temporarily move and live alone (tanshin-funin), leaving the family behind. Two hundred and thirty-nine (239) taido-funin transferees, 247 tanshin-funin transferees, and 225 non-transferred employees completed a 31-item questionnaire designed to measure stress responses on the present level. Factor analysis found five factors for the stress: feeling of instability, poor health, loneliness, loss of self-confidence, and feeling of elation. Results indicated that (1) in general, tanshin-funin transferees felt more stressful than the other groups. However, family separation might not be as bad as expected, because while it did cause loneliness and poor health and decrease feeling of elation, the transferee self-confidence was actually increased. (2) The transferee rank did not affect the effects of family separation. (3) Besides, stress responses were measured on 31-items on the difference between present and past levels. According to the results, tanshin-funin transferees believed that psychological stress due to family separation was especially harmful. The effects of family separation depended also on the conceptual levels of measurement.

Adult↗
PubMedDate not supplied

Nursing student perceptions of public health issues in Ghana.

This article reports survey results to Ghanaian nursing students' perceptions of public health issues. Their views were ascertained through a questionnaire designed to capture ratings of educational curriculum concerns and perceptions of the importance of public health factors. Both frequency data and chi-square analysis were used to assess the ordinal position of health factors and gender differences, respectively. Chi-square analysis was also done to assess differences by age. Differences between men and women respondents existed on six of 15 health factors (p less than .05) including malaria, heart disease, measles, cancer, malnutrition and car accidents, while differences between age groups were found on two of the 15 factors (violence and cancer). Based on the ascertained student perceptions, current efforts in Ghana suggest that preventive health is an emerging concern to public health officials. As such, Ghanaian nursing students hold perceptions not dissimilar to those of U.S. health professions students.

Adult↗
PubMed1989

Auricular injury and the use of headgear in wrestlers.

Questionnaires designed to assess attitudes and use of headgear were completed by 537 Division I collegiate wrestlers. Only 35.2% of the wrestlers wore headgear all of the time during practice as opposed to 92.4% during competition, which was a statistically significant difference. The most common reason for not wearing headgear was discomfort (35%). There were 482 participating in nonschool team events, and 203 (42%) described headgear use as "seldom or never." However, there was a statistically significant difference of developing auricular hematoma while wearing headgear (26%) vs not wearing headgear (52%). There were 208 (39%) who reported a permanent auricular deformity resulting from an injury that occurred with (10.6%) or without (26.6%) headgear. These results suggest that headgear provides only partial protection and that nonuse is widespread, causing a surprisingly high frequency of permanent auricular deformities.

Adolescent↗