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PubMed2007

A concept analysis of self-monitoring.

AIM: This paper reports a concept analysis delineating and clarifying the concept of self-monitoring to facilitate development and evaluation of interventions to enhance self-monitoring. BACKGROUND: The concepts of self-monitoring, self-management, self-care and symptom management are often used in similar or interchangeable ways. Clarification of the concept of self-monitoring is needed for research and theory development. METHOD: Rodgers and Knafl's evolutionary concept analysis process was used to delineate and clarify the concept. The PubMed and CINAHL databases were searched using keywords 'self-monitoring', 'self-management' and 'self-care' (with and without the hyphen) for the years 1998-2005, to update a previous study (not published). Later, searching was refined and the keyword 'self-monitoring' was paired with 'awareness' and 'self-regulation' was added. Approximately half the papers were from nursing (n = 34) and half from other disciplines (n = 32). The sample from 1998 to 2005 was further stratified by chronic condition. Definition, exemplars, usage, attributes, antecedents/consequences and implications for further study were identified. FINDINGS: Self-monitoring was composed of two complementary components (attributes): (1) awareness of bodily symptoms, sensations, daily activities, and cognitive processes and (2) measurements, recordings and observations that inform cognition or provide information for independent action or consultation with care providers. CONCLUSION: Self-monitoring may be an important concept for understanding how people self-manage chronic conditions. This concept analysis may be useful for researchers who wish to measure this dimension and to develop nursing theory in this area.

Awareness↗

PubMed2006

Self-monitoring and close relationships.

Three types of close relationships have received attention from theorists and researchers interested in self-monitoring: friendships, romantic relationships, and marriage. Our review of this literature was organized around three phases of relationships: initiation, maintenance, and dissolution. Across the three types of relationships, consistent differences between high self-monitors and low self-monitors emerged concerning the structure of their social relationships (segmented vs. integrated), the basis for choosing friends and romantic partners (activity-based vs. person-based), and the orientation taken to romantic and marital partners (uncommitted vs. committed). Across all three types of relationships, however, little is known about the processes and consequences involved in the dissolution of close relationships for high self-monitors and low self-monitors. Relatively little is also known about the processes used by high self-monitors and low self-monitors to maintain their friendships and marriages. In addition to addressing these deficiencies in the literature, theorists and researchers interested in self-monitoring and close relationships need to develop sophisticated, causal models that can account for (a) interaction exchanges in the relationships, (b) dyadic as well as individual levels of analysis, and (c) temporal and situational changes in the course of close relationships.

Acculturation↗

PubMed2004

Changes in reality monitoring and episodic memory in early childhood.

The purposes of this research were to examine the developmental relation between reality monitoring and episodic memory, to link reality monitoring to autobiographical memory by using extended naturalistic events, and to examine prefrontal functioning as a potential contributor to development in reality monitoring and episodic memory. In Experiment 1, 4-year-olds were worse than 6- or 8-year-olds at reality monitoring after a week delay, despite the fact that they remembered more about real than imagined events and remembered different aspects of each. In Experiments 2 and 3, reality monitoring and episodic memory were evaluated for 4- and 6-year-olds immediately after the events occurred and, in Experiment 3, again after a week delay. Reality monitoring was at higher levels for both age groups, but age differences remained. These data suggest that preschoolers' difficulties with reality monitoring result from a combination of episodic memory deficits and strategic differences. In addition, correlation analyses more directly linked preschoolers' reality monitoring to episodic memory and supported the hypothesis that episodic memory development is related to prefrontal functioning.

Age Factors↗

PubMed2006

Practices and views on fetal heart monitoring: a structured observation and interview study.

OBJECTIVE: To assess and explain deviations from recommended practice in National Institute for Clinical Excellence (NICE) guidelines in relation to fetal heart monitoring. DESIGN: Qualitative study. SETTING: Large teaching hospital in the UK. SAMPLE: Sixty-six hours of observation of 25 labours and interviews with 20 midwives of varying grades. METHODS: Structured observations of labour and semistructured interviews with midwives. Interviews were undertaken using a prompt guide, audiotaped, and transcribed verbatim. Analysis was based on the constant comparative method, assisted by QSR N5 software. MAIN OUTCOME MEASURES: Deviations from recommended practice in relation to fetal monitoring and insights into why these occur. RESULTS: All babies involved in the study were safely delivered, but 243 deviations from recommended practice in relation to NICE guidelines on fetal monitoring were identified, with the majority (80%) of these occurring in relation to documentation. Other deviations from recommended practice included indications for use of electronic fetal heart monitoring and conduct of fetal heart monitoring. There is evidence of difficulties with availability and maintenance of equipment, and some deficits in staff knowledge and skill. Differing orientations towards fetal monitoring were reported by midwives, which were likely to have impacts on practice. The initiation, management, and interpretation of fetal heart monitoring is complex and distributed across time, space, and professional boundaries, and practices in relation to fetal heart monitoring need to be understood within an organisational and social context. CONCLUSION: Some deviations from best practice guidelines may be rectified through straightforward interventions including improved systems for managing equipment and training. Other deviations from recommended practice need to be understood as the outcomes of complex processes that are likely to defy easy resolution.

Attitude of Health Personnel↗

PubMed1992

Telephone fetal heart rate monitoring in South Australia.

A pilot trial was conducted to assess the technical feasibility of long range fetal heart monitoring by telephone in an Australian setting. The indications for such monitoring and patient ability and attitude towards self-monitoring was also assessed. One hundred and fifty seven tracings were received from 57 women using a simple doppler device to transmit fetal heart sounds to the central hospital fetal monitor. Thirty three of the patients were in country hospitals and 24 were at home. Gestation ranged from 26 to 42 weeks' gestation. Eighty six percent of the country hospital tracings and 94% of the home tracings were easily interpretable. The large majority of tracings were normal and appeared to encourage conservative management by the attendants. Two tracings were abnormal and these influenced early delivery in both cases. Nearly all women using the monitor at home found the procedure easy and reassuring. Tracings from country hospitals were initiated usually after an acute antenatal complication, whereas the indications for home-monitoring were prompted by longer-term, medium-risk factors. Home-monitoring may reduce the inconvenience and expense of inpatient or outpatient care and country hospitals without electronic fetal monitors may benefit from such a service. The selection of patients who might benefit from such technology remains controversial and warrants a prospective randomized controlled trial.

Cardiotocography↗

PubMed1997

Laboratory testing of the Spiegelberg brain pressure monitor: a technical report.

OBJECTIVES: The Spiegelberg brain pressure monitor is a low cost intracranial pressure monitoring system that has been used clinically for some time, mainly in Germany. To provide a rigorous bench comparison of the Spiegelberg monitor with the Camino pressure monitor an evaluation programme has been carried out in the UK Shunt Evaluation Laboratory. DESIGN: Drift over 72 hours and with temperature, a frequency response, and the accuracy of measurement of both static and pulsatile pressures have been tested simultanously in Camino and Spiegelberg transducers using a computerised rig. RESULTS: Long term zero drift was less than 0.7 mm Hg in both transducers. The Spiegelberg monitor showed no temperature drift whereas the Camino monitor had a drift of around 0.3 mm Hg/degrees C. The Spiegelberg monitor underread mean pressures <40 mm Hg by <1 mm Hg, but the error increased to 4.7 mm Hg at 100 mm Hg. The frequency bandwidth of the Spiegelberg monitor was 4 Hz at a low pressure. Underreading of the amplitude increased with the mean pressure, with a delay of about 0.1 s in the detection of the peaks of pulse waveform. CONCLUSION: The Spiegelberg transducer had excellent accuracy for static intracranial pressure measurement, but complex waveform analysis may be biased by its limited dynamic response.

Clinical Laboratory Techniques↗

PubMed2004

Self-monitoring as an intervention to decrease swimmers' stroke counts.

Self-monitoring of stroke count by swimmers is a common coaching strategy, it is but one that has little data to support it. Although research has demonstrated that self-monitoring can motivate behavior change, little research has focused on whether self-monitoring can enhance skill development. The purpose of the present set of studies was to examine the effects of self-monitoring on the improvement of a specific swimming skill (i.e., stroke count). Eight adult fitness swimmers and three college-level competitive swimmers participated in Study 1. In an A-B-A design, swimmers were observed to reduce stroke counts by about one stroke per lap when instructed to self-monitor and to verbally report strokes. In Study 2. swimmers self-monitored and visually reported strokes on a dry-erase board. A greater improvement was observed in five out of six swimmers. Across studies, stroke counts generally returned to baseline levels when self-monitoring was ended, and improvements during both self-monitoring phases were the greatest in the weakest swimmers. Limitations of the research, mechanisms of change, and implications for coaches are discussed.

Adult↗

PubMed2004

Home care artificial heart monitoring system via internet.

The availability of a remote management system, which provides both physiological-related information about the patient and device-related information about the implanted device, would be helpful during in vivo experiments or clinical trials involving artificial heart implantation. In order to be able to monitor the course of the in vivo experiment continuously regardless of the patient's location, an internet-based remote monitoring system was developed, which can monitor physiological-related information such as pressure (AoP, LAP, RAP, PAP) and flow data, as well as device-related information such as current, direction and pump operating conditions. The home care artificial heart monitoring system which we developed consists of four main components, which are the transcutaneous information transmission system (TITS), local monitoring station (LMS), data server station (DSS), and client monitoring station (CMS). The device-related information and physiological-related information can be transmitted in real time from a patient in a remote non-clinical environment to the specialist situated in a clinic depending on the current capabilities and availability of the internet. The local monitoring station situated at the remote site is composed of a data acquisition and preprocessing unit connected to a computer via its RS-232 port, and which communicate using a Java-based client-server architecture. The remote monitoring system so developed was used during an in vivo experiment of the artificial heart implantation for 2 months and performed successfully according to design specifications.

Animals↗

PubMed1997

Laser monitoring of chest wall displacement.

We developed a prototype laser monitor, consisting of a single laser sensor, to observe chest wall displacement during respiration. With this monitor, respiratory waveforms are expressed as an anterioposterior motion of the chest wall. The purpose of this study was to examine the characteristics and performance of this prototype. Performance was assessed: 1) under static conditions; 2) using a lung model ventilated in both conventional and high frequency oscillation (HFOV) modes; and 3) during spontaneous breathing in normal adults. In vitro, the monitor performed well both under static conditions and during mechanical ventilation. Reliable "respiratory" wave forms, with no frequency-dependent change in the relationship between displacement and volume, were produced during both conventional ventilation and HFOV at 15 Hz. In vivo, abdominal displacement, measured in the midline, was linearly correlated with the tidal volume signal integrated from flow. The waveforms produced by the monitor were adequate for monitoring respiration and for calculating respiratory timing variables. While a single laser sensor is unlikely to be sufficient for monitoring respiration in spontaneously breathing subjects, the performance of the prototype monitor was sufficiently impressive to encourage further development and further study of this type of truly noninvasive respiratory monitor.

Abdomen↗

PubMed2000

GSM cell phones can interfere with ionizing radiation dose monitoring equipment.

Cell phone use is growing worldwide. These phones transmit to adjacent base stations using radiofrequency signals in the microwave range (approximately 900-approximately 1800 MHz). Portable electronic dose monitoring equipment is used in hospitals and other institutions to monitor and control levels of exposure to ionizing radiation, and to reassure staff. The objective of this paper is to investigate the effect of mobile phones on a sample of dose monitoring devices. Two mobile phones (Siemens C25 and Motorola CD930) were used in the study. Field strengths were measured to be in the range 0 V m-1 to over 100 V m-1, depending on the distance from the phone, and were strongest at the beginning of a call. Personal electronic dosemeters (n = 7), portable dose monitors (n = 4) and contamination monitors (n = 2) were assessed. All the units were in service. Three of the personal dosemeters showed abnormal responses when exposed to mobile phone transmission. One dosemeter (Siemens EPD-2) registered doses equivalent to a dose rate of 99 mSv h-1. In addition, two of the portable dosemeters and one of the contamination monitors also gave an abnormal response. Interference was observed across a number of detector types from a number of manufacturers. Modern cell phones can interfere with ionizing radiation dose monitoring equipment. This should be taken into account when distributing these devices and when assessing results generated by them. Electromagnetic compatibility testing should form part of the commissioning and specification protocol for new dose monitoring equipment.

Electromagnetic Fields↗

PubMed2004

Prejudice on the stage: self-monitoring and the public expression of group attitudes.

According to self-monitoring theory (Snyder, 1987), high self-monitors tailor their self-presentation for the sake of desired public appearances, whereas low self-monitors are relatively unlikely to practice such situationally guided impression management strategies. It was therefore predicted that, when asked to publicly express their attitudes regarding a social group, high self-monitors would modify their expressive behaviour in a direction consistent with the attitudes attributed to their audience. Conversely, low self-monitors would be unaffected by their audience's attitude towards this group. A study was conducted to test this hypothesis: participants, whose level of self-monitoring and prejudice towards homosexuals had been previously measured, were asked to report their thoughts regarding this group in an open-ended manner. They anticipated discussing these thoughts with an audience perceived as either prejudiced or tolerant, or they expected that their responses would remain private. In line with predictions, high self-monitors expressed more prejudice when the audience was perceived as prejudiced than tolerant, whereas low self-monitors were not affected by the audience's attitude.

Adult↗

PubMed2003

Comparison of home oximetry monitoring with laboratory polysomnography in children.

STUDY OBJECTIVES: To measure the accuracy and reliability of a portable home oximetry monitor with an automated analysis for the diagnosis of obstructive sleep apnea (OSA) in children. DESIGN: Prospective cohort study. SETTING: Alberta Lung Association Sleep Center, Alberta Children's Hospital Sleep Clinic. STUDY SUBJECTS: Consecutive, otherwise healthy children, aged 4 to 18 years, presenting to the Pediatric Sleep Service at the Alberta Children's Hospital for assessment of possible OSA. INTERVENTIONS: All subjects underwent 2 nights of monitoring in the home with an oximetry-based portable monitor with an automatic internal scoring algorithm. A third night of monitoring was done simultaneously with computerized laboratory polysomnography according to American Thoracic Society guidelines. MEASUREMENTS AND RESULTS: Both test-retest reliability of the portable monitor-based desaturation index (DI) between 2 nights at home and between laboratory and home were high using the Bland and Altman analysis (mean agreement, 0.32 and 0.64; limits of agreement, - 8.00 to 8.64 and - 0.75 to 6.50, respectively). The polysomnographic apnea-hypopnea index (AHI) agreed poorly with the portable monitor DI (mean difference, 1.27; limits of agreement, - 12.02 to 15.02). The sensitivity and specificity of the monitor for the identification of moderate sleep apnea (polysomnography AHI > 5/h) were 67% and 60%, respectively. CONCLUSION: Portable monitoring based only on oximetry alone is not adequate for the identification of OSA in otherwise healthy children.

Adolescent↗

PubMed2005

Reduction in red blood cell transfusions among preterm infants: results of a randomized trial with an in-line blood gas and chemistry monitor.

BACKGROUND: Critically ill, extremely premature infants develop anemia because of intensive laboratory blood testing and undergo multiple red blood cell (RBC) transfusions in the early weeks of life. To date, researchers have had only limited success in finding ways to reduce transfusions significantly in this patient population. OBJECTIVE: To reduce RBC transfusions for these infants by using a point-of-care bedside monitor that returns analyzed blood to the patient. DESIGN, SETTING, AND PATIENTS: This was a prospective, 2-center, randomized, open, controlled, clinical trial with a 1:1 assignment of extremely low birth weight infants (weighing 500-1000 g at birth) to control or monitor groups and analysis with the intention-to-treat approach. Predefined RBC transfusion criteria were applied uniformly in the 2 groups. INTERVENTIONS: Clinical treatment of study subjects with an in-line, ex vivo, bedside monitor that withdraws blood through an umbilical artery catheter, analyzes blood gases and sodium, potassium, and hematocrit levels, and returns the sample to the patient. MAIN OUTCOME MEASURES: The total volume and number of RBC transfusions during the first 2 weeks of life and the total volume of blood removed for laboratory testing. RESULTS: The trial was terminated prematurely when one center's NICU changed its standard method of laboratory testing. In the first 2 weeks of life, there was a nonsignificant 17% lower cumulative RBC transfusion volume in the monitor group (n = 46), compared with the control group (n = 47). However, data from the first week only (the period of greater catheter use) demonstrated a significant 33% lower cumulative RBC transfusion volume in the monitor group. Cumulative phlebotomy loss was approximately 25% less in the monitor group throughout the 2-week study period. There was no difference between groups in neonatal mortality, morbidity, and neurodevelopmental outcome rates at 18 to 24 months. This is the first randomized trial documenting that RBC transfusions administered to neonates can by reduced by decreasing laboratory phlebotomy loss. CONCLUSIONS: As long as an umbilical artery catheter is available for blood sampling with an in-line blood gas and chemistry monitor, significant reductions in neonatal RBC transfusions can be achieved. The patients most likely to benefit from monitor use are the smallest, most critically ill newborns.

Anemia, Neonatal↗

PubMed2006

Parental rules and monitoring of children's movie viewing associated with children's risk for smoking and drinking.

OBJECTIVES: Evidence suggests that media portrayals of tobacco and alcohol use are important predictors of adolescent smoking and drinking. We examined the role of parents in monitoring and limiting children's movie exposure and whether or not this was associated with a lower risk of adolescent smoking and drinking. DESIGN: We surveyed 2606 child-parent dyads between 2002 and 2003. We asked children (9-12 years of age) how often their parents engaged in specific behaviors to monitor their movie viewing and if their parents allowed them to watch R-rated movies. We also surveyed children about parental monitoring of nonmedia-related behaviors. The primary outcomes were risk of smoking and drinking alcohol, defined by attitudinal susceptibility or early experimentation with either substance. RESULTS: Less than half (45.0%) the children were prohibited from watching R-rated movies. Of those who were allowed to watch R-rated movies, one third (34.7%) always viewed them with a parent and two thirds (65.3%) sometimes watched them without a parent. Less than 10% of the children reported that their parents consistently engaged in all 4 movie-monitoring behaviors. Even after controlling for parental monitoring of nonmedia-related behaviors and other covariates, children were at lower risk of smoking and drinking if their parents prohibited them from watching R-rated movies. Parental coviewing of R-rated movies was associated with a lower risk of child smoking but not drinking if parents consistently monitored what their children watched. CONCLUSIONS: Parental rules and monitoring of children's movie viewing may have a protective influence on children's risk for smoking and drinking, over and above parental monitoring of nonmedia related behaviors. This highlights a potential role for parents in preventing early initiation of tobacco and alcohol use among adolescents.

Alcohol Drinking↗

PubMed1999

PACS in sonography: accuracy of interpretation using film compared with monitor display. Picture archiving and communication systems.

OBJECTIVE: The goal of this study was to determine the relative accuracy of interpretation of sonography when viewed on a monitor or on film. MATERIALS AND METHODS: Four radiologists twice interpreted a series of 440 sonograms using the following sequences of display formats for initial and second interpretations: film-film, film-monitor, monitor-film, and monitor-monitor. Reporting discrepancies between the initial and subsequent interpretation were reviewed by an arbitration panel unaware of the display mode. Results were analyzed for differences in error rate attributable to film versus monitor display format, chronology of interpretation, individual observer, and observer seniority. RESULTS: We found no statistically significant difference in the error rate for film (10.3%) versus monitor display format (14.6%) (p = .09). Likewise, we found no significant differences in the error rates attributable to chronology of interpretation (p = .13), individual observer (p = .54), or observer seniority (p = .87). CONCLUSION: Interpretative accuracy is similar whether sonograms are interpreted on a monitor or on film.

Artifacts↗

PubMed1995

Improved detection of silent cardiac ischemia with a 12-lead portable microprocessor-driven real-time electrocardiographic monitor.

OBJECTIVE: To compare a microprocessor-driven real-time 12-lead electrocardiographic monitoring device with Holter monitoring for detection of ischemia. DESIGN: Electrocardiographic monitoring was conducted in 110 patients at bed rest or undergoing surgical procedures. MATERIAL AND METHODS: In three groups of patients, simultaneous monitoring with a 12-lead real-time device and a 2-channel Holter system was performed to detect ischemic episodes. The differences in the number of ischemic events and the total time of ischemia revealed by the two devices were analyzed statistically. RESULTS: In patients with coronary artery disease, more ischemic ST-segment shifts were detected by the 12-lead device than by Holter monitoring (44 versus 16 events; P < 0.05). Total time of ischemia was also greater with the 12-lead device (879 versus 273 minutes; P < 0.05). Ischemia was detected by both techniques in 6 patients, only by the 12-lead device in 12, and only by Holter monitoring in 1. Neither device detected ischemia in control subjects. The 12-lead device had an advantage in detecting inferior ischemia, and it identified an additional 13 patients with unstable angina who had changes in T-wave polarity but did not exhibit ST-segment shifts. CONCLUSION: The 12-lead real-time electrocardiographic monitoring device is superior to Holter monitoring in detecting and facilitating real-time identification of myocardial ischemia in patients at bed rest.

Angina, Unstable↗

PubMed2005

[Effects of repetition and dual-task on output monitoring errors].

We investigated output-monitoring errors in a modified source-monitoring paradigm. Unlike the traditional paradigm that involves two phases, learning and monitoring, the modified paradigm involves three phases, learning, enactment, and monitoring. Three experiments produced two major findings. First, compared with the traditional paradigm, the modified paradigm produced fewer monitoring errors. Second, performing a dual-task during the enactment phase increased monitoring errors for the items that participants repeatedly enacted during the learning phase. In contrast, performing a dual-task during the learning phase did not influence monitoring errors. It only decreased the number of items that were enacted during the enactment phase. We concluded that monitoring errors are more likely to occur (a) when the modality of items matches between the learning and enactment phases (i.e., items are enacted during both phases), and (b) when a dual-task increases processing demands during the enactment phase.

Adult↗

PubMed1999

[Distributions of the numbers of monitoring stations in the surveillance of infectious diseases in Japan].

To describe the characteristics of monitoring stations for the infectious disease surveillance system in Japan, we compared the distributions of the number of monitoring stations in terms of population, region, size of medical institution, and medical specialty. The distributions of annual number of reported cases in terms of the type of diseases, the size of medical institution, and medical specialty were also compared. We conducted a nationwide survey of the pediatrics stations (16 diseases), ophthalmology stations (3 diseases) and the stations of sexually transmitted diseases (STD) (5 diseases) in Japan. In the survey, we collected the data of monitoring stations and the annual reported cases of diseases. We also collected the data on the population, served by the health center where the monitoring stations existed, from the census. First, we compared the difference between the present number of monitoring stations and the current standard established by the Ministry of Health and Welfare (MHW). Second, we compared the distribution of all medical institutions in Japan and the monitoring stations in terms of the size of the medical institution. Third, we compared the average number of annual reported cases of diseases in terms of the size of medical institution and the medical specialty. In most health centers, the number of monitoring stations achieved the current standard of MHW, while a few health centers had no monitoring station, although they had a large population. Most prefectures also achieved the current standard of MHW, but some prefectures were well below the standard. Among pediatric stations, the sampling proportion of large hospitals was higher than other categories. Among the ophthalmology stations, the sampling proportion of hospitals was higher than other categories. Among the STD stations, the sampling proportion of clinics of obstetrics and gynecology was lower than other categories. Except for some diseases, it made little difference in the average number of annual reported cases of diseases in terms of the type of medical institution. Among STD, there was a great difference in the average number of annual reported cases of diseases in terms of medical specialty.

Child↗