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PubMedDate not supplied

Patient education: effects of two teaching methods upon parental retention of infant feeding practices.

PURPOSE: The purpose of this study was to test a strategy for improving patient's retention of discharge teaching. METHODOLOGY: A pretest-posttest experimental design was used. Forty postpartum women were randomly assigned to a group. All subjects received infant feeding instruction until they reached criterion on the Infant Feeding Questionnaire. The experimental group received additional instruction on the same material (overlearning). The two groups were compared 2 weeks later on the same questionnaire. Mean scores were compared by a t-test, demographic variables were correlated to outcomes, and effect of race or culture was analyzed by ANOVA. FINDINGS: The pretest showed no significant difference between the groups. Posttest scores were significantly higher for the experimental group. The mother's education was the only demographic variable that was correlated to the results. CONCLUSION: Mothers who receive overlearning beyond the mastery level retain significantly more of the material.

Adolescent↗
PubMed1995

Predictive testing for Huntington's disease: risk perception, reasons for testing and psychological profile of test applicants.

In the Center for Human Genetics in Leuven, predictive DNA-testing for Huntington's disease is available as a clinical service since November 1987, initially by DNA-linkage and since mid 1993 by direct mutation analysis. The multidisciplinary approach as well as the detailed test protocol are described. The present paper gives a sociodemographic description of the test applicants, their subjective evaluation of the risk and their motives for requesting the predictive test. Major attention is paid to the personality profile of the applicants who proceeded with testing. Psychometric testing revealed that this group of test applicants did not differ significantly from the general population for most characteristics and even had a number of more positive characteristics e.g. a higher ego-strength. The latter may reflect a self-selection of a more resourceful and emotionally healthier subgroup of at-risk persons. Nevertheless psychological evaluation also has identified a number of applicants with extremely high anxiety levels and other problems, who needed extra pretest and posttest counseling. The relatively high number of withdrawals from the test programme is another indication of the importance of adequate pretest counseling.

Adult↗
PubMed1994

Involvement of hippocampal NMDA and AMPA receptors in acquisition, formation and retrieval of spatial memory in the Morris water maze.

This study investigated the roles of hippocampal N-methyl-D-aspartate (NMDA) receptors and alpha-amino-3-hydroxyl-5-methyl-4-isoxazole propionate (AMPA) receptors in acquisition, consolidation and retrieval processes of spatial memory. Male Wistar rats with indwelling cannulae in the dorsal hippocampus received 4 training trials on the Morris water maze for consecutively 6 days. Rats received infusion of the NMDA receptor antagonist 2-amino-5-phosphonopentanoic acid (AP5) or the AMPA receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) into the hippocampus under one of the three schedules: 5 min prior to each daily training session, immediately after each daily training session or 5 min prior to the final testing trial. Pretraining intra-hippocampal infusion of 5.0 micrograms AP5 retarded acquisition. The same dose of AP5 given after training had little effect but a higher dose (10.0 micrograms) did slow down progress in the acquisition curve. Pretest infusion AP5 failed to affect memory retrieval. Pretraining intra-hippocampal infusion of 1.0 micrograms CNQX also impaired acquisition, but posttraining infusion of CNQX at 1.0 or 2.0 micrograms had no effect. However, pretest infusion of 1.0 micrograms CNQX markedly impaired retrieval of the already-formed spatial memory. These findings taken together suggest that acquisition in a spatial task involves hippocampal NMDA and AMPA receptors, consolidation of spatial memory involves NMDA receptors and retrieving such memory involves AMPA receptors.

2-Amino-5-phosphonovalerate↗
PubMed1994

Evaluation of a theory-based HIV prevention intervention for college students.

This study tested the effectiveness of a workshop for college students designed to increase HIV-preventive behavior by increasing participants' self-efficacy concerning HIV-preventive behavior. The Safer Sex Efficacy Workshop (SSE workshop) was compared with a lecture on HIV (HIV lecture) and a lecture on an unrelated topic, family violence (FV lecture); the effect of each condition on self-efficacy, behavioral intentions, and HIV-preventive behavior was assessed. Participants in the SSE workshop and the HIV lecture increased more from pretest to posttest in self-efficacy and the intention to use a condom than participants in the FV lecture. Participants in the SSE workshop increased their frequency of condom use from pretest to two-month follow-up more than participants in either of the two control conditions. Changes in the frequency of participants' discussion of AIDS and past partners with sexual partners and the intention to discuss did not differ among the three intervention conditions.

Adult↗
PubMed1995

Coaching persons with lung cancer to report sensory pain. Literature review and pilot study findings.

Because clinicians often do not recognize that patients have pain and patients do not spontaneously communicate their pain, clinicians may fail to prescribe or administer adequate pain medications. One method of improving clinicians' assessments of pain is to coach patients to communicate their pain in ways that clinicians recognize. The aims of our pilot study were to (a) examine the feasibility of implementing a randomized clinical trial of a COACHING protocol in 18 outpatients with lung cancer pain and (b) estimate the effects of COACHING on nurses' knowledge of patients' pain location, intensity, quality, and pattern. The expectation was that COACHING would show a trend toward reducing the discrepancy between patients self-report of sensory pain and sensory pain data known to nurse clinicians. Patients were randomly assigned to be COACHED or NOT-COACHED (usual care) and pretest-posttest measures with the McGill Pain Questionnaire (MPQ) and Visual Analogue Scale (VAS) were taken from nurses and patients. Patients- and nurse-completed MPQs and VASs were compared for agreement. Improvement in percent agreement occurred consistently more often (pretest to posttest) between patient self-report of sensory pain and nurses' pain assessments in the COACHED group than in the NOT-COACHED group. Pilot study findings demonstrated feasibility of implementing the COACHING protocol and suggest that COACHING may be effective in reducing discrepancies between patients' self-reports and nurses' assessments of sensory pain. Design modifications are recommended for implementation of future studies.

Communication↗
PubMed1995

A new method of infant monitoring: for use at home and hospital.

AIM: To test a New Zealand originated, designed and funded remote infant heart rate monitor in the home and hospital settings (temporarily named the King Monitor) for accuracy and reliability. METHODS: The units were pretested using ECG simulators and on infants already being monitored in the neonatal unit. Longer term trials on hospital infants and infants being simultaneously monitored at home were then conducted. RESULTS: Interference and electrode problems were corrected during the pretesting phase. The unit worked accurately when compared with the standard neonatal heart and respiratory rate monitor in hospital and appeared in some infants to give earlier warning of problems than the standard home apnoea monitor. CONCLUSION: This simple to use monitor worked reliably and accurately under a wide variety of settings and with varying sized infants. In addition, the lack of direct connection between the infant and the control unit allowed freedom of movement of normal infants around the cot or bassinet. The monitor will require to be adapted for portable use at home and during travel.

Electrocardiography↗
PubMed1994

Teaching residents to use asthma devices. Assessing family residents' skills and a brief intervention.

OBJECTIVE: To evaluate an educational program for family medicine residents on using selected inhaler devices for delivery of asthma medications. DESIGN: A prospective analysis using pretests and posttests of a nonrandomized study group and control group. The study group of residents was given an instructional manual and a set of devices for home study, followed by a 1-hour tutorial session with a clinical instructor that included a video and hands-on practice. SETTING: Family medicine centres in Edmonton hospitals. PARTICIPANTS: The study group consisted of a convenience sample of 23 first- and second-year family medicine residents at the Misericordia Hospital Family Medicine Centre. The control group consisted of a convenience sample of 22 first- and second-year family medicine residents at the Royal Alexandra Hospital Family Medicine Centre. Nine residents did not take the posttest; one was absent because of injury, one missed the in-service, and seven had left the city on other rotations, had completed their program, or declined to participate. MAIN OUTCOME MEASURES: Improvements in scores on a multiple-choice test and in techniques of using the devices. RESULTS: Using an average of scores on seven different devices, only 36% of residents showed adequate knowledge of how to use the devices on the pretest. Posttest scores improved for both the control (P < 0.001) and study (P < 0.001) groups, but improvement was significantly greater for the study group (P < 0.001). CONCLUSIONS: Residents lacked adequate knowledge of asthma devices. More study is needed to confirm the long-term effectiveness of formal teaching about the devices.

Asthma↗
PubMed1994

Influence of vitamin E on aflatoxicosis in growing swine.

Effects of dietary aflatoxin (AF) and supplemental vitamin E (d-alpha-tocopherol) were evaluated in growing crossbred pigs. Nine barrows (3 replicates of 3 each, mean body weight, 14.0 kg) per group were assigned to 1 of 4 treatment groups (for a total of 36 barrows): 0 IU of supplemental vitamin E and 0 mg of AF/kg of feed (control); 2,400 IU of vitamin E divided into equal doses and administered IM on days 1 and 16; 2.5 mg of AF/kg of feed; or 2.5 mg of AF/kg of feed plus 2,400 IU of vitamin E administered similarly to treatment 2. Barrows were administered their respective treatment for 32 days. Evaluations were made for group production performance and for serum biochemical, immunologic, hematologic, pathologic, serum and tissue tocopherol, and serum retinol variables. Body weight was reduced by AF-alone and AF plus vitamin E treatments, compared with control and vitamin E-alone treatments. Liver weight was increased for the AF alone-treated and the AF plus vitamin E-treated barrows, compared with control barrows. The AF alone-treated barrows had alterations in:serum values of alkaline phosphatase, gamma-glutamyltransferase, albumin, glucose, phosphorus, calcium, cholesterol, total iron, unsaturated iron-binding capacity, total iron-binding capacity, and urea nitrogen; RBC numbers, hematocrit, hemoglobin concentration, and prothrombin time; and mitogen-induced lymphoblastogenic responses. With the exception of some slight ameliorating effects on hematologic measurements, supplemental treatment with vitamin E did not prove beneficial against the toxicosis-associated AF treatment. The AF alone-treated barrows had decreased serum tocopherol and retinol concentrations, compared with control and pretest values, and decreased tocopherol concentration in cardiac tissue. High parenterally administered doses of vitamin E did not have sparing effect on AF-induced reductions of serum tocopherol or retinol concentration; however, compared with pretest values, serum tocopherol concentration was increased by vitamin E-alone treatment. Tocopherol concentration in cardiac tissue of the AF plus vitamin E-treated barrows was increased over that of the AF alone-treated barrows, indicating an ameliorating effect on AF-induced tissue concentrations reductions. These data indicate that vitamin E may not have a sparing effect on AF-induced toxicosis and that AF may reduce serum retinol and serum and tissue tocopherol concentrations.

Administration, Oral↗
PubMed1994

A randomized, controlled clinical trial of education and physical training for women with fibromyalgia.

OBJECTIVE: To determine the effectiveness of self-management education and physical training in decreasing fibromyalgia (FMS) symptoms and increasing physical and psychological well being. METHODS: A pretest-posttest control group design was used. Ninety-nine women with FMS were randomly assigned to 1 of 3 groups; 86 completed the study. The education only group received a 6-week self-management course. The education plus physical training group received the course and 6 h of training designed to assist them to exercise independently. The control group got treatment after 3 months. RESULTS: The experimental programs had a significant positive impact on quality of life and self-efficacy. Helplessness, number of days feeling bad, physical dysfunction, and pain in the tender points decreased significantly in one or both of the treated groups when retested 6 weeks after the end of the program. Longterm followup of 67 treated subjects showed significant positive changes on the Fibromyalgia Impact Questionnaire primarily in the physical training group. Among all subjects, 87% were exercising at least 3 times/week for 20 min or more; 46% said they had increased their exercise level since participating in the program; 70% were practicing relaxation strategies as needed; 46% were working at least half time as opposed to 37% at pretest. CONCLUSION: Self-efficacy of the treated groups was enhanced significantly by the program. Other changes were smaller and more delayed than had been expected. Recommendations for future trials include a longer education program, more vigorous physical training, and longterm followup.

Adult↗
PubMed1993

Evaluation of the National Cancer Institute's clinical trials booklet.

Evaluating the impact of written materials is a means to enhance the effectiveness of patient education, yet few controlled studies of publications have been completed. In 1984, as a result of a needs assessment, the National Cancer Institute (NCI) developed and pretested the booklet "What Are Clinical Trials All About?" The booklet was designed to help cancer patients make informed decisions about participation in clinical trials, which are critical for improving cancer treatment. The booklet, which is currently available, has been used internationally as a model for communicating information on clinical trials. Since 1985, the booklet has been used by the Cancer Information Service (CIS) as an educational tool for answering questions from cancer patients about treatment and clinical trials. The CIS, which has traditionally assisted NCI in the development and testing of educational materials, was involved in the pretesting and particularly the posttesting of this booklet. The CIS regional offices at Fox Chase Cancer Center and Sylvester Comprehensive Cancer Center together with National Institutes of Health Clinical Center and North Memorial Medical Center conducted a posttest evaluation of the booklet's effectiveness for cancer patients. Two hospitals tested the booklet on patients who were eligible for a specific clinical trial, and two hospitals tested the booklet on patients who were theoretically eligible for a clinical trial (with a cancer site and stage for which a trial existed). Patients were randomly assigned: 203 experimental subjects received the booklet, and 194 control subjects were not given the booklet until after a 2-week posttest examining attitudes, knowledge, and beliefs about clinical trials.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude↗
PubMed1994

Sequential dual-isotope SPECT imaging with thallium-201 and technetium-99m-sestamibi.

UNLABELLED: This study examined the results of sequential SPECT dual-isotope imaging with 201Tl and 99mTc-sestamibi in 148 patients, 114 of whom also had coronary angiography and 34 had < 5% pretest probability for coronary artery disease (CAD). METHODS: Stress thallium/rest sestamibi was used in 82 patients and rest thallium/stress sestamibi in 66 patients. Coronary angiography showed that 17 patients had no CAD, 27 patients had one-vessel CAD, 41 patients had two-vessel CAD and 29 patients had three-vessel CAD. The thallium study (3 mCi) was always done before the sestamibi study (20-25 mCi). The stress was either symptom-limited treadmill exercise testing or adenosine infusion at a rate of 140 micrograms/kg/min for 6 min. RESULTS: The study was completed within 2 hr. The stress and rest images were normal in 11 of 17 patients (65%) with no CAD by angiography and in 33 of 34 patients with a low pretest probability of CAD (normalcy rate = 97%). The images were abnormal in 75 patients with CAD (77%). The perfusion pattern was compared to wall motion in 485 segments (97 patients) assessed by contrast ventriculography. There were no or reversible perfusion defects in 357 of 386 segments (92%) with no wall motion abnormality. CONCLUSION: Sequential dual-isotope imaging is feasible and can be completed in a short period of time and may therefore enhance laboratory throughput and patient convenience.

Aged↗
PubMed1994

Does myocardial perfusion scintigraphy demonstrate clinical usefulness in patients with markedly positive exercise tests? An assessment of the method in a high-risk subset.

To evaluate the clinical utility of perfusion scintigraphy in patients with markedly positive exercise ECGs, we studied 94 consecutive patients with markedly positive exercise ECGs; 74 of them were also studied with scintigraphy. Patients undergoing scintigraphy had an intermediate pretest likelihood of coronary disease and were divided into two groups: those with reversible defects involving one complete area or aspects of multiple vascular areas (group 1, 38 patients), and those with normal scintigrams and reversible defects in a limited aspect of one vascular area, isolated fixed defects, or both (group 2, 36 patients). Among all demographic and exercise variables, only a hypotensive or blunted blood pressure response and scintigraphic lung uptake or cavitary dilation, although insensitive, were more frequent in group 1 (all p < 0.05). All 36 patients in group 1 and 14 of 18 in group 2 who underwent coronary angiography had significant coronary lesions; 31 in group 1 but only seven in group 2 had multivessel disease (p < 0.05). Subsequently 32 patients in group 1 had revascularization compared with only two patients in group 2. Only one cardiac event was noted among 34 patients in group 2 who were followed for a mean of 38 months while they were being treated medically. However, four of nine patients in group 1 initially treated medically required late revascularization because of clinical progression of disease, and one patient died (p < 0.05). Compared with patients having scintigraphy, patients not imaged had a higher pretest likelihood of coronary disease, a higher incidence of angina, unstable angina, and induced angina, with a lower exercise time and time to ST depression (p < 0.05). All underwent angiography, and 16 had multivessel disease. Not all patients with markedly positive exercise ECGs were at similarly high coronary risk. Some with high-risk coronary anatomy were identified without the use of scintigraphy. In others, where diagnosis and prognosis were less clear, scintigraphy aided in the diagnosis and accurately identified a low-risk subgroup as did no other parameter.

Aged↗
PubMed1994

Effects of professional development seminars on role conception, role deprivation, and self-esteem of generic baccalaureate students.

This study compared differences in role conception (professional, bureaucratic, and service), role deprivation, and self-esteem among baccalaureate students enrolled in specially designed professional development seminars. More than 100 students participated in the pretests, given on entry to the program, of which 63 completed both the pretest and the posttest given on program exit. The Corwin Role Conception Scale assessed role conceptions and role deprivation and the Coopersmith Adult Form Self-Esteem Inventory assessed self-esteem. Statistically significant differences were found within groups in bureaucratic role conceptions (P = .0009) and self-esteem (P = .0019) and between groups in professional role conception (P = .0057). No differences were found between or within groups for service role conception or role deprivation.

Adult↗
PubMed1993

Influence of education on self-perceived attitudes about HIV/AIDS among human services providers.

Participants in a number of different HIV/AIDS educational programs, varying in content, length of course, and student audience, were surveyed to determine if education could help reduce fear and increase comfort in work with HIV/AIDS clients. It was hypothesized that attitude scores would improve following exposure to the educational programs. A retrospective pretest-posttest survey design consisting of Likert statements was used. A t test for paired samples determined if attitude scores improved following exposure to the educational programs. An analysis of variance determined if significant differences in pretest and posttest scores existed among the groups. Within groups, there was a positive increase in self-assessed attitude scores. Multiple group comparisons indicated significant differences between groups that appear to be related to program content and length. Workplace risk and whether a program was elective may have also been factors affecting attitude.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Reminiscence: a viable option to enhance power in elders.

The purpose of this study was to investigate the usefulness of reminiscent storytelling as a therapeutic modality to enhance the sense of power in well elders (ages 60-86). The study was conceptualized within Rogers' (1986) Science of Unitary Human Beings and focused on Barrett's theory of power. A pre- and posttest design with experimental and control groups was used with Barrett's Power as Knowing Participation in Change Test, Version II as the measure of power (personal control). Experimental group subjects were pretested and then participated in three reminiscence sessions during a 1-week period. Subjects were then posttested both at the end of the reminiscence sessions and again after a 5-week interval. Control group subjects were tested on a schedule identical to that of the experimental group, but participated in no reminiscence sessions. Although an overall significant difference (p = 0.003) in scores was found over the testing period, no differences were found between experimental and control groups. Both experimental (n = 34) and control (n = 41) groups demonstrated a small but insignificant decrease in power between the pretest and posttest 1. Both groups then experienced a significant increase in power between posttest 1 and posttest 2. It is recommended that research energies continue to be directed toward the investigation of this topic. In our contemporary high tech world which often allows minimal human contact and diminishing quality of life for the aged, novel modalities such as reminiscence offer a human to human exchange, which may hold the key to this modern-day challenge.

Aged↗
PubMedDate not supplied

Quality of life after coronary angioplasty.

OBJECTIVE: To explore the impact of percutaneous transluminal coronary angioplasty (PTCA) on perceived quality of life and health-related quality of life. DESIGN: One-group, pretest-posttest design. Pretest data were collected the evening before PTCA and posttest data were collected 4 to 6 weeks after PTCA. Data were collected from medical records, structured interview, and mailed questionnaire. SETTING: University-affiliated, Midwestern medical center. PATIENTS: Forty patients undergoing PTCA. OUTCOME MEASURES: Perceived quality of life was assessed by use of the Ferrans and Powers Quality of Life Index. Health-related quality of life was assessed in terms of cardiac symptoms, tolerance of physical activity, exercise capacity, perceived general health, return to work, and lifestyle changes. INTERVENTION: PTCA. RESULTS: Perceived quality of life increased significantly due to increased satisfaction with health and functioning rather than changes in other areas of life. Significant improvements were found in cardiac symptoms (decreased incidence of chest pain and frequency of cardiac symptoms), tolerance of physical activity (decrease in symptoms with activity, increase in number of blocks able to walk, and decrease in interference with recreational activities because of symptoms), treadmill tests, and perceived general health. Regarding lifestyle changes, significant numbers of subjects quit smoking and increased their frequency of exercise, but the majority reported cheating on their prescribed diets. CONCLUSIONS: PTCA was found to result in significant improvements in perceived quality of life and health-related quality of life.

Adult↗
PubMed1995

Risk communication: a tool for behavior change.

This chapter presents some of the theories and models underpinning effective communication practice. It also emphasizes the central role of communication in achieving effective program implementation. Whether the communication is aimed at changing the attitudes and behavior of professionals, various segments of the public, or other target audiences, the basic approach is the same. The following checklist provides a guide to program planners (Arkin 1991): Commit adequate time, effort, and resources to communication planning and pretesting. Begin by singling out specific issues and specific target audiences. Then design messages based on the target audiences' values, needs, and interests. Conduct (or review existing) market research on the target audience to understand what will motivate them. Pretest messages and materials with the target audience to assure understanding and relevance to their needs and interests. Make sure that messages and materials appear where the target audience will pay attention to them (for sensitive issues, community and interpersonal channels that allow interactive discussion are very important). Produce public service announcements that are of high quality, community specific, marketed to stations, and targeted to audiences likely to see them when public service air time is available (such as fringe viewing times). Combine public service announcements with news and other uses of the mass media (e.g., building on related news) to increase exposure to issues. Use a combination of the mass media and community channels that will reach the target audience. Work collaboratively with other organizations, including drug treatment facilities, law enforcement and social service agencies, and other community organizations that have complementary strengths. Begin to coordinate efforts as early as possible in program planning. Use a multipronged communication strategy to focus on what an individual should do, how the individual can start to change, and factors that help reinforce individual change, such as peer approval and community support. Track progress and identify when, and what kind of, changes are needed in communications. Combine communications with other strategies needed to support change (e.g., access to treatment or positive alternatives to drug use). Set reasonable, short-term communication objectives to reach the long-term goal. Then, commit to communications as one program component over the long term. It is important to remember that one-shot campaigns are unlikely to have a lasting effect and that progress is incremental.

Behavior↗
PubMed1994

An in vivo comparison of antimicrobial activities of four commercial mouthwashes.

The purpose of this in vivo double-blind study was to determine and compare the antimicrobial effectiveness of four commercial over-the-counter mouthwashes and a water control. Two of the products tested contained alcohol (Listerine and Scope) and two products were alcohol-free (Rembrandt Mouth Refreshing Rincs and Clear Choice). The antimicrobial efficacy of the products was determined against aerobic, microaerophilic, and anaerobic bacteria in saliva. Thirty human subjects participated in the study. At each experimental session for a given subject, a pretest saliva sample was taken. This sample was divided and used to grow three bacteria cultures under the different incubation environments. After giving the pretest sample, the subject rinsed with one of the commercial mouthwashes or the water control for 30 seconds, then waited one hour at which time a posttest saliva sample was collected. Again, the sample was divided and used to culture the different type of bacteria. Following a 48-hour incubation period, the numbers of microbial colonies on each plate were counted and compared. The results indicated that all of the mouthwashes tested performed significantly better than the water control. Both of the non-alcohol-containing products showed efficacy in inhibiting aerobic, microaerophilic, and anaerobic bacteria. Rembrandt Mouth Refreshing Rinse and Listerine inhibited all three types of bacteria, and were not significantly different from each other in efficacy. The Rembrandt mouth wash inhibited all three types of bacteria more effectively than Clear Choice mouthwash, and inhibited two of the three types of bacteria more effectively than Scope mouthwash.

Analysis of Variance↗