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The effect of sleep loss on next day effort.

The study had two primary objectives. The first was to determine whether sleep loss results in a preference for tasks demanding minimal effort. The second was to evaluate the quality of performance when participants, under conditions of sleep loss, have control over task demands. In experiment 1, using a repeated-measures design, 50 undergraduate college students were evaluated, following one night of no sleep loss and one night of sleep loss. The Math Effort Task (MET) presented addition problems via computer. Participants were able to select additions at one of five levels of difficulty. Less-demanding problems were selected and more additions were solved correctly when the participants were subject to sleep loss. In experiment 2, 58 undergraduate college students were randomly assigned to a no sleep deprivation or a sleep deprivation condition. Sleep-deprived participants selected less-demanding problems on the MET. Percentage correct on the MET was equivalent for both the non-sleep-deprived and sleep-deprived groups. On a task selection question, the sleep-deprived participants also selected significantly less-demanding non-academic tasks. Increased sleepiness, fatigue, and reaction time were associated with the selection of less difficult tasks. Both groups of participants reported equivalent effort expenditures; sleep-deprived participants did not perceive a reduction in effort. These studies demonstrate that sleep loss results in the choice of low-effort behavior that helps maintain accurate responding.

Adolescent↗

Nurse--client relationships: the experience of community psychiatric nurses.

The aim of the present study was to construct an interpretation of the experience of the nurse--client relationship in the context of community psychiatric nursing. Hermeneutic phenomenology formed the framework of the study. Shared conversations were conducted with five experienced community psychiatric nurses and five clients. Themes of 'Being there', 'Being concerned', 'Establishing trust' and 'Facilitating transition' were identified from the nurses' conversations. This thematic structure was used to illuminate the centrality of the nurse--client relationship, and to articulate the skills that are involved in establishing and maintaining the relationship with clients with mental illness.

Adult↗

Conserving the vitality of suffering: addressing family constraints to illness conversations.

When persons are confronted with life-threatening or chronic illness, there is always a possibility that family members other than the person experiencing the illness also suffer as they attempt to manage their own distress. This paper describes exemplars from a hermeneutic study that explored therapeutic conversations between nurses and families who were living with a member experiencing ischaemic heart disease. These conversations uncovered the complexity of both individual and family suffering following acute cardiac illness events, and called attention to nursing practices that addressed some of the ways that family members were constrained from having conversations about the illness. When spaces were created for these conversations to occur, possibilities for making sense of illness and suffering were revealed as vital. These understandings support the efforts of family members to sustain and conserve family relationships in the face of illness and suffering, and inform both the professional and personal lives of nurses.

Adaptation, Psychological↗

The nature of touch therapy related to Ki: practitioners' perspective.

Touch therapy related to Ki, a type of healing touch, has been regarded as one of the distinct therapeutic modalities in traditional oriental medicine. The present study attempted to develop a substantive theory about helping patients using touch therapy related to Ki, by exploring the views of practitioners who are using this therapeutic modality within the context of the Korean society. A grounded theory approach was applied during the collection and analyses of data. The core category, main categories and trajectory of helping patients during the use of touch therapy related to Ki was delineated. Helping patients while using touch therapy related to Ki was found to be a dynamic process with each participant actively engaged in increasing the activating, potential power of the human being. These findings have value in understanding the embedded meaning of the healing process through touch therapy within the context of Ki.

Adult↗

Early postsurgery experience of prostate cancer patients and spouses.

PURPOSE: The authors describe the experience of men with prostate cancer and their spouses in the early recovery period after surgery. DESCRIPTION OF STUDY: As part of a longitudinal qualitative study, semistructured interviews were held with 34 patients who had prostate cancer and their spouses 8 to 10 weeks after surgery. RESULTS: Five components of experience emerged from the interviews: 1) hearing news about the extent of their cancer after surgery influenced how patients viewed their cancer experience and, in many cases, their recovery; 2) men placed great emphasis on recovering their physical capacity quickly; 3) couples connected with each other through working out care routines and managing periods of irritability; 4) couples described a range of responses to surgery side effects and complications; and 5) the meaning of cancer varied for couples, with most seeing the experience as a temporary disruption. CLINICAL IMPLICATIONS: Physicians, nurses, social workers, and other health professionals working with patients before and after prostatectomies may assist couples to prepare better for the early recovery period by being both sensitive to the men's need to recover physical capacity quickly while helping them to understand that recovery takes time. Accurate information about expected periods of irritability, side effects, and possible complications would diminish the likelihood of distress during this period.

Activities of Daily Living↗

Community health workers: examining the Helper Therapy principle.

A community approach to the integration of health and social services for low-income pregnant women is being addressed through Community Integrated Service System (CISS) initiatives of the Maternal Child Health Bureau. This particular CISS program model was designed to enable low-income mothers to function in a Community Health Worker (CHW) role providing social support for at-risk pregnant women. Using Riessman's notion of "helper therapy," the model was also developed to enhance the potential for CHWs to gain helper benefits. The purpose of this exploratory study was to describe perceived helper benefits and stressors associated with the CHW role and to examine the usefulness of an instrument developed to assess benefits and stressors. The study findings revealed that the majority of CHWs perceived helper benefits that included positive feelings about self, a sense of belonging, valuable work experience, and access to health information and skills through training or contact with program staff. Stressors such as feeling inadequate to help, however, were associated with the helper role for some CHWs. Preliminary analysis of the Helper's Perception Measure indicated that it may be an effective measure and should be tested with a larger sample of CHWs.

Adult↗

Childhood brain tumors: children's and siblings' concerns regarding the diagnosis and phase of illness.

Our objective was to identify commonly reported problems and helpful resources important to children with brain or spinal cord tumors and siblings during phases of illness. Affected children and siblings from 40 families responded to a regional survey. Items encompassed four general content areas: health care provider interactions, medical information/education, health care utilization, and psychosocial. Children rated individual items as helpful, a problem, and for importance; relative frequencies were derived. One-third or more affected children reported important problems: hospitalization/surgery--help with schoolwork; hospital discharge--help with changes in physical activity, appearance, moods, special needs at school; adjuvant treatment--Internet information, help with moods; and remission--socializing. One-third or more siblings reported important problems: diagnosis--information about etiology and prognosis, manner of physician and parents in providing information; hospitalization/surgery--information about prognosis, help with schoolwork; hospital discharge--help with schoolwork; adjuvant treatment--help with changes in sister or brother's appearance, physical activity, moods, and information about the treatment; end of life--treatment of sister's or brother's pain, information about dying, family harmony, support from friends, help with schoolwork, and preparation for the death. Consideration of problems and helpful resources will provide the framework for developing and evaluating intervention strategies at each phase of illness.

Adaptation, Psychological↗

Can you work?

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Altruism↗

The role of the personal tutor in the academic context.

This paper is the second of a series on the role of the nurse teacher and is based on a review of the literature and the personal experience of the authors. Identifying the most appropriate way to support students in both the academic and clinical setting has been a major concern for nurse teachers. The move of nurse education into the higher education arena has increased the diverse nature of the nurse teachers role and raised questions about the nature and function of the personal tutor in relation to students undertaking nursing courses. This paper discusses the concept of the personal tutor, with particular focus on the academic aspects of the role. The time implication of adopting an all encompassing personal tutor role, within the current climate of higher education, is considered. The paper also highlights that the roles tutors adopt in practice are diverse and usually as a result of convenience rather than identified outcomes.

Counseling↗

Fetal ethology and its relevance to perinatal medicine.

Fetal ethology means fetal activity and behavioral states in the uterine environment. Behavioral states may be defined by various measurable physiological variables, such as heart and respiratory rates, eye movements, body tone and body movements. Fetal motor behavior provides information about the early stages of the neurodevelopmental process. Movement was the first aspect of fetal behavior, the clinical significance of which became was recognized. Fetal behavior provides an opportunity for studying motor, sensory and cognitive functions in the fetus. Behavior can be utilized to study the immediate well-being of the fetus. The latter can be compromised as a result of a number of pathological factors. In high risk pregnancies, the study of fetal behavior may help the clinician to establish the optimum time for the delivery.

Cognition↗

[The stigma of mental illness from the patient's view--an overview].

QUESTION: This study provides an overview of the research on subjective stigmatization of mentally ill people. METHOD: All articles on this topic that have been published since the mid 1980 were analyzed. RESULTS: Mentally ill people are exposed to stigmatization in many ways. The anticipated and experienced stigmatizations as well as their attempts chosen for coping have fatal effects on their social relationships, their working situation, and their quality of life. The same is true for the emotional well-being and the self-esteem of the ill. In addition, the fear of stigmatization has a negative effect on the help seeking behavior and the compliance of the ill with the psychiatric treatment. CONCLUSION: Efforts aimed at reducing stigmatization of mentally ill people should not be confined to fighting the discrimination objectively existing, but should also take into consideration the subjective stigma experiences of the persons affected.

Adaptation, Psychological↗

[How to care for homeless mentally ill men in the community - a randomised intervention study].

OBJECTIVE: The aim of the present study was to clarify whether the mediation of homeless persons identified as mentally ill into the sociopsychiatric or the help-seeking system can be facilitated by a short-term intervention. METHOD: Probands with at least one psychiatric diagnosis according to ICD-10 (73 % of the sample) were randomized to the intervention group (manualized procedure with five brief contacts) or to the control group (no intervention). The course of the contacts and the further help-seeking behavior after 4 and 8 months were registered. RESULTS: The very sporadic participation of the patients in the therapeutic discussion permitted a manualized procedure in individual cases only. The establishment of contact was very successful, but the problem-centered procedure only within limits. The intergroup comparison revealed no fundamental differences in the utilization of offers of support during the course of the study. Overall, however, the number of users tended to increase, with an increased contact frequency being recorded especially among those participating in therapeutic discussions. CONCLUSIONS: Only a relatively small proportion of the clientele can be reached through short-term behavior therapy. Fundamentally a low-profile, primarily outreach-based offer founded on longer-term contact appears to be more promising.

Adult↗

[Adjuvant and drug therapy of chronic pain in the head and neck area].

Head and neck pain caused of benign or malignant disease reduces remarkable the patient's quality of life. In the following are presented adjuvant and medicamentous methods for pain control. Surgery, irradiation and chemotherapy aim to diminish the tumor extension and reduce algesic transmitting substances in the periphery. Nerve blocs, cryoanalgesia and transcutaneous electrical nerve stimulation lead to an interruption of the painful spinal reflex arc. Active, passive and relaxation exercises prevent from dolorific muscular tensions. Psychological treatment, so as relaxation techniques in connection with behavior therapy, helps to develop coping strategies. The mainstay of pain relief is effective use of analgetics which should be given orally if possible, on a regular schedule and on an individualized basis according with the WHO guidelines.

Analgesics, Opioid↗

Spouses as adjuncts in fluency therapy.

Couples with one partner who stutters completed questionnaires about the fluent partners' awareness of their spouses' stuttering; their general knowledge about stuttering; how fluent spouses had helped their partners; and the nature and benefits of spousal participation in therapy. Findings strongly suggested that spouses may be helpful in therapy. Considerations and suggestions for involving spouses are made on the basis of these findings and those of surveys completed by speech-language pathologists (SLPs) who include spouses in fluency therapy.

Female↗

On being a nurse.

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Helping Behavior↗