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PubMed1997

Behavioural hearing tactics: a controlled trial of a short treatment programme.

Nineteen elderly hearing impaired subjects participated in an experimental treatment study and received either behavioural hearing tactics or served as untreated controls. Treatment was supplied in the form of a self-help treatment manual supplied with telephone contacts during 4 consecutive weeks. The treatment manual included applied relaxation, communication strategies training, advice to relatives, information, and coping skills. Assessments (pre-post) were conducted in a structured interview measuring coping behaviour. In order to evoke behavioural compensation small acoustic provocations were included in the interview. Pre-post assessments also included questionnaires, daily registered hearing problems, and hours of daily hearing aid use. Results showed significant beneficial effects in favour of the treatment in terms of self-assessed problems and behaviour change.

Adaptation, Psychological↗
PubMedDate not supplied

Participant reactions to a cognitive-behavioral guided self-help program for binge eating: developing criteria for program evaluation.

This article evaluates the effectiveness of a telephone-based guided self-help program for women who binge eat. We report how key program components (e.g., phone sessions, the self-help book) contribute to the four self-help goals identified in the clinical literature: (1) decrease isolation/increase support; (2) increase knowledge of the problem; (3) broaden coping skills; and (4) improve self-esteem. Using the example of our feasibility study, we illustrate that even minimal interventions create a relational context which can promote entry into and engagement with treatment. We conclude that program evaluation should include not only traditional measures of outcome (e.g., reduction in symptomatology), but utilize outcome measures related to the specific goals of minimal interventions (e.g., changes in help-seeking behavior).

Attitude↗
PubMed2002

Developing emergency nursing competence.

Developing and maintaining the competence emergency nurses need is an important function of emergency clinical nurse specialists (CNS), educators, and other members of the emergency department (ED) leadership team. A thorough orientation is the first and most important step in developing the competence of emergency nurses. After orientation, the challenge is to maintain currency of practice in the face of incessant change such as new medications, new equipment, and new therapies in emergency care. This article focuses on the orientation of emergency nurses. A related article in this issue addresses assessment of competency.

Clinical Competence↗
PubMedDate not supplied

The MacArthur Foundation Depression Education Program for Primary Care Physicians: background and rationale.

In order to improve the assessment and management of depression in general medical care, the John D. and Catherine T. MacArthur Foundation supported the development, evaluation, and dissemination of an eight-hour depression education program (DEP) for primary care physicians. This publication includes a paper describing the background and educational rationale for the program structure, the complete participant's workbook, and a facilitator's guide for teaching the program. Given in two separate four-hour workshops by a psychiatrist and a primary care physician, DEP is delivered to small groups of learners (about 12) using an interactive adult learning model and multiple teaching techniques including targeted yet flexible objectives, two lectures, videotape demonstration and discussion, role-play exercises, a focused monograph on depression, an interview checklist, structured assessment and outcomes tools, clinical case studies, and audiotape review of actual patient interviews. DEP has been shown in a prospective randomized trial to improve physicians' interview-ing skills as well as simulated-patient satisfaction scores. Over 150 PCPs in four states have taken DEP in more than 30 separate programs given by 24 trained facilitators. Participants, despite a wide diversity of background knowledge and skills, have uniformly reported remarkably positive learner satisfaction with all dimensions of the Program.

Depression↗
PubMed1988

Intraosseous infusions by prehospital personnel in critically ill pediatric patients.

A program to instruct ground and aeromedical prehospital emergency medical system providers in the intraosseous infusion technique was developed and implemented. Paramedics and flight nurses received training through lectures and performance of the procedure in several animal models. The records of attempts on 15 patients who subsequently received intraosseous infusions were then reviewed. An intraosseous infusion was successful in 12 of 15 attempts (80%), and all needles were placed in less than 30 seconds. Drugs administered included phenobarbitol, phenytoin, atropine, epinephrine, sodium bicarbonate, isoproterenol, and pancuronium. Observed complications were limited to minimal subcutaneous infiltration in three cases and slow infusion in another. No serious sequelae were noted, but most patients did not survive and the ability of this study to detect sequelae may be limited. These data suggest that intraosseous infusion is a safe and reliable technique in the prehospital setting. Research is needed to study this technique in more detail.

Aircraft↗
PubMed1996

Self-paced learning stations for tuberculosis respirator training: report of a pilot program.

BACKGROUND: In response to the Centers for Disease Control and Prevention's recently issued "Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Facilities, 1994," during May 1994 we implemented and evaluated a pilot tuberculosis respirator training program that used four self-directed learning stations, through which participants proceeded at their own pace. Employee tuberculin skin testing was included in the training program. METHODS: The time required to train each employee was recorded. At the completion of the training program, all participants were asked to assess their ability to attain the learning objectives and whether they believed the program format was an effective and efficient use of their time. Two weeks later, a convenience sample of 100 employees completed an 11-question test designed to measure knowledge retention. RESULTS: One hundred seventy-six employees completed training during the pilot period. The average time necessary to train each employee was 19.5 minutes. Overall 97.1% of participants stated that they were able to fully meet the course objectives. Test scores among the convenience sample averaged 88% 2 weeks after training. CONCLUSIONS: The use of self-paced stations for tuberculosis respirator training and employee tuberculosis skin test screening was both effective and time-efficient for employees. We have expanded this program to include all of our approximately 500 employees who may be exposed to tuberculosis.

Educational Measurement↗