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Clinical effectiveness in nursing最新文献

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Gender differences in self-esteem in Chinese acute coronary syndrome patients 中国急性冠脉综合征患者自尊的性别差异
Pub Date : 2004-09-01 DOI: 10.1016/j.cein.2005.05.001
Colin R. Martin, David R. Thompson, Dominic S. Chan

Objective

Self-esteem is an intrinsic psychological domain to recovery following an acute coronary event. However, little research has explored gender differences in self-esteem in the recovery of cardiac patients. The current investigation sought to determine if gender differences in self-esteem were present in acute coronary syndrome (ACS) patients following hospitalization.

Design

A mixed-group design was used with gender and observation point (within one week of onset of ACS and at six month follow-up) as independent variables.

Setting

Patients were recruited from one general university teaching hospital in Hong Kong, with a confirmed diagnosis of myocardial infarction or unstable angina.

Main outcome measure

The 10-item Rosenberg Self-Esteem Scale (RSES; [Society and the Adolescent Self-image, Princeton University Press, Princeton, New Jersey, 1965]).

Results

Analysis of covariance revealed a highly significant effect on RSES scores with male patients having greater RSES-rated self-esteem compared to females. No significant improvement in RSES scores were observed at six month follow-up.

Conclusions

Health professionals need to be aware that gender is an important factor in the self-esteem needs of this clinical group. Given the importance of self-esteem to cardiac rehabilitation practice, the finding of no improvement in self-esteem at follow-up highlights the need to assess this important psychological domain.

目的自尊是急性冠状动脉事件后恢复的内在心理域。然而,很少有研究探讨自尊在心脏病患者康复中的性别差异。目前的研究旨在确定急性冠脉综合征(ACS)患者住院后是否存在自尊的性别差异。设计采用混合组设计,以性别和观察点(ACS发病1周内和随访6个月)为自变量。患者从香港一所综合性大学教学医院招募,确诊为心肌梗死或不稳定型心绞痛。10项罗森博格自尊量表(RSES;[社会与青少年自我形象,普林斯顿大学出版社,普林斯顿,新泽西,1965])。结果协方差分析显示,与女性相比,男性患者具有更高的自尊,对RSES评分有极显著的影响。在6个月的随访中,RSES评分没有明显改善。结论卫生专业人员需要意识到性别是影响该临床群体自尊需求的重要因素。鉴于自尊对心脏康复实践的重要性,在随访中发现自尊没有改善,这突出了评估这一重要心理领域的必要性。
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引用次数: 1
Perceptions of effective advice in pregnancy – The case of activity 对孕期有效建议的认识-以活动为例
Pub Date : 2004-09-01 DOI: 10.1016/j.cein.2005.03.002
Harriet Gross , Penny E. Bee

Objectives

The paper uses qualitative and quantitative data arising from a longitudinal study of pregnant women to examine women’s responses to advice provided about changing their behaviour during pregnancy.

Design

A longitudinal study over nine months involving a semi-structured questionnaire and interview schedule together with a range of psychological measures and activity measurement using actimetry. The purpose of the main study was to explore maternal daily activity in low-risk pregnancy.

Participants

57 women volunteers aged (mean age 26.3 years) with low-risk pregnancy, recruited via an East Midlands City Centre teaching hospital antenatal clinic.

Results

Data on advice suggest that 1) response to advice is extremely varied and that reduction in activity is not always welcome; 2) factors affecting women’s responses to advice include the importance they attach to an active lifestyle in pregnancy.

Conclusions

The paper highlights the inherent difficulties of providing effective advice during the short period of pregnancy; the need for clear and consistent messages to be provided by all health professionals involved in antenatal care as well as the difficulty of changing cultural expectations of pregnancy-appropriate behaviours.

目的:本文利用对孕妇进行的一项纵向研究得出的定性和定量数据,调查妇女对有关在怀孕期间改变行为的建议的反应。设计一项为期9个月的纵向研究,包括半结构化问卷调查和访谈计划,以及一系列心理测量和使用活动测量法的活动测量。主要研究的目的是探讨低风险妊娠期间产妇的日常活动情况。参与者:57名年龄(平均26.3岁)低风险怀孕的女性志愿者,通过东米德兰兹市中心教学医院产前诊所招募。结果:关于建议的数据表明:1)对建议的反应千差万别,减少活动并不总是受欢迎的;影响妇女对建议的反应的因素包括她们对怀孕期间积极生活方式的重视。结论本文强调了在短期妊娠期提供有效建议的内在困难;参与产前保健的所有保健专业人员需要提供明确和一致的信息,以及改变对适当怀孕行为的文化期望的困难。
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引用次数: 25
Towards the development of a tool to assess educational needs in patients with arthritis 开发一种评估关节炎患者教育需求的工具
Pub Date : 2004-06-01 DOI: 10.1016/j.cein.2004.06.001
Bernadette Hardware , E. Anne Lacey , Jane Shewan

Objective:

This article describes the initial development and testing of an educational needs assessment tool for patients with arthritis in the UK.

Design:

Following formative development of the tool, the study took the form of a test–retest questionnaire study. Participants were asked to complete the tool on two occasions, separated by two weeks, to assess reliability.

Setting:

Subjects were recruited from the out-patient department of a district general hospital in the north of England.

Participants:

The sample consisted of 97 patients with arthritis recruited consecutively from a rheumatology out-patient department.

Main outcome measures:

Scores from the questionnaire were the main outcome measure used. Additional variables included gender, age, educational level, and duration of disease.

Results:

The tool was well received by patients. Higher scores, indicating greater educational needs, were recorded by women, older people, those with lower levels of education, and those with shorter disease duration. The greatest educational needs were in the domain of information about arthritis itself. The tool demonstrated good test–retest reliability.

Conclusion:

The tool showed some validity and reliability, and was acceptable to patients. Further development work is needed if the tool is to be used in interventional studies.

目的:本文描述了英国关节炎患者教育需求评估工具的初步开发和测试。设计:在工具形成性开发之后,本研究采用测试-重测问卷研究的形式。参与者被要求在两种情况下完成该工具,间隔两周,以评估可靠性。环境:受试者从英格兰北部一家地区综合医院的门诊部招募。参与者:样本包括从风湿病门诊部连续招募的97名关节炎患者。主要结果测量:问卷得分是使用的主要结果测量。其他变量包括性别、年龄、教育水平和疾病持续时间。结果:患者对该工具反应良好。妇女、老年人、受教育程度较低的人和疾病持续时间较短的人得分较高,表明教育需求更大。最大的教育需求是关于关节炎本身的信息。该工具证明了良好的测试-重测试可靠性。结论:该工具具有一定的效度和信度,为患者所接受。如果要将该工具用于介入性研究,则需要进一步的开发工作。
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引用次数: 43
Pub Date : 2004-06-01 DOI: 10.1016/j.cein.2004.10.002
Elaine Hill (Senior Lecturer in Operating Department Practice)
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引用次数: 0
Ethnicity, diversity and research ethics 种族、多样性和研究伦理
Pub Date : 2004-06-01 DOI: 10.1016/j.cein.2004.12.004
Rob Newell
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引用次数: 0
A pilot study of a self-help manual with minimal therapist contact in the treatment of obsessive–compulsive disorder 一项关于自助手册的初步研究,在治疗强迫症的过程中尽量减少治疗师的接触
Pub Date : 2004-06-01 DOI: 10.1016/j.cein.2004.05.004
Karina Lovell , David Ekers , Anne Fulford , Clare Baguley , Tim Bradshaw

Objectives:

The two main aims of this pilot study was to (1) develop a self-help manual (facilitated by a therapist) for people with obsessive–compulsive disorder and (2) to investigate whether effective CBT for OCD can be delivered via a therapist-facilitated CBT self-help manual.

Design:

A pilot study using an uncontrolled repeated measures design.

Setting:

A specialist cognitive behaviour therapy department, West Hampshire NHS Trust.

Participants:

Seven consecutive clients referred to a CBT department whose main presenting difficulty was OCD, met inclusion criteria and agreed and consented to participate in the study.

Main outcome measures:

The main outcome measure was the Yale Brown Obsessive Compulsive Checklist (YBOC’s) and a measure of depression and social functioning were administered at pre and post treatment and at 1-, 3-, and 6-month follow-up.

Results:

Results indicated good clinical outcome and nurses can deliver effective support to patients using a self-help manual with obsessive–compulsive disorder.

Conclusions:

Although the results are promising, further work is required with larger numbers, longer follow-up and economic evaluation under controlled conditions.

目的:本试点研究的两个主要目的是:(1)为强迫症患者制定一份自助手册(由治疗师协助);(2)调查是否可以通过治疗师协助的CBT自助手册来有效地治疗强迫症。设计:采用无控制重复测量设计的初步研究。环境:西汉普郡国民保健服务信托的专业认知行为治疗部门。参与者:连续7名以强迫症为主要表现困难,符合纳入标准并同意参加本研究的患者转介到CBT部门。主要结果测量:主要结果测量是耶鲁布朗强迫症检查表(YBOC’s),在治疗前和治疗后以及1个月、3个月和6个月的随访中进行抑郁和社会功能测量。结果:临床效果良好,护理人员可以有效地支持强迫症患者使用自助手册。结论:虽然结果是有希望的,但需要进一步的工作,更大的数量,更长时间的随访和控制条件下的经济评价。
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引用次数: 15
Research governance and the art of defence 研究治理和防御艺术
Pub Date : 2004-06-01 DOI: 10.1016/j.cein.2005.01.001
R. Kneafsey, M. Howarth
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引用次数: 1
Maternal perceptions of early breastfeeding experiences and breastfeeding outcomes at 6 weeks 母亲对早期母乳喂养经历和6周母乳喂养结果的看法
Pub Date : 2004-06-01 DOI: 10.1016/j.cein.2004.08.001
Danuta Wojnar

Objective:

To explore whether breastfeeding status at 6 weeks postpartum is related to the mother’s perceptions of her infant’s behavior, the breastfeeding experience itself, and of herself as a mother during postpartum hospitalization.

Design:

A prospective correlational design.

Setting:

A tertiary care setting in Eastern Canada.

Participants:

One hundred and ten women who met the inclusion criteria were recruited from the postpartum unit. The majority were primaparous, over 25 years of age, well educated, and had partners.

Outcome measures:

(1) Maternal perceptions of the overall infant behavior, of the breastfeeding experience, and of herself using the Mother and Baby Scales (MABS) neonatal (Wolke, D., 1995. St. James Roberts and Wolke Mother and Baby Scales (MABS) (1986,1995). In: Brazelton, T.B., Nugent, J.K. (Eds.), Neonatal Behavioral Assessment Scale. Clinics in Developmental Medicine 137, 135–137) and (2) breastfeeding rates at 6 weeks postpartum.

Results:

At 6 weeks postpartum, 80 (74.8%) participants were breastfeeding and 27 (25.8%) had stopped. Maternal perceptions of infant alertness/responsiveness (A) (r = 0.54, p < 0.01), irritability during feeds (IDF) (r = −0.34, p < 0.01) and lack of confidence in feeding (LCF) (r = 0.33, p < 0.01) of the MABS neonatal scales were significantly correlated with breastfeeding status at 6 weeks. At 6-week telephone follow-up, the majority of women reported positive breastfeeding experiences, which included feelings of enhanced attachment, enjoyment and a sense of pride and fulfillment. Participants indicated that learning about infant states, behaviors, and cues contributed to their positive feelings about the baby and enjoyment of breastfeeding. Negative experiences were related to perceived insufficient milk supply, illness, and incompatibility of lactation with personal needs and life style.

Conclusions:

The findings highlight the importance of maternal perceptions of their infant’s behavior and of self as a mother in sustaining breastfeeding. In the absence of personal and social pressures to stop breastfeeding, interventions that begin with how to look at feeding from an infant perspective may be the best starting point to a successful breastfeeding.

目的:探讨产后6周母乳喂养状况是否与产后住院期间母亲对婴儿行为的认知、母乳喂养体验本身以及自己作为母亲的认知有关。设计:前瞻性相关设计。环境:位于加拿大东部的三级医疗机构。参与者:从产后单位招募了110名符合纳入标准的妇女。大多数是原生女,年龄在25岁以上,受过良好教育,有伴侣。结果测量:(1)使用母婴量表(MABS)新生儿(Wolke, D., 1995),母亲对婴儿整体行为、母乳喂养经历和自己的感知。圣詹姆斯罗伯茨和沃尔克母婴量表(MABS)(1986年,1995年)。见:Brazelton, t.b., Nugent, J.K.(编),新生儿行为评估量表。发育医学诊所137,135-137)和(2)产后6周母乳喂养率。结果:产后6周,80名(74.8%)参与者仍在母乳喂养,27名(25.8%)参与者已停止母乳喂养。母亲对婴儿警觉性/反应性的感知(A) (r = 0.54, p <0.01),饲养期间烦躁(IDF) (r = - 0.34, p <0.01)和饲养信心不足(LCF) (r = 0.33, p <新生儿MABS评分0.01)与6周母乳喂养状况显著相关。在6周的电话随访中,大多数妇女报告了积极的母乳喂养经历,包括依恋感增强、享受感、自豪感和成就感。参与者表示,了解婴儿的状态,行为和线索有助于他们对婴儿的积极感受和母乳喂养的乐趣。负面体验与乳量不足、疾病和哺乳与个人需求和生活方式不相容有关。结论:研究结果强调了母亲对婴儿行为和作为母亲的自我认知在维持母乳喂养中的重要性。在没有个人和社会压力要求停止母乳喂养的情况下,从如何从婴儿的角度看待喂养开始的干预措施可能是成功母乳喂养的最佳起点。
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引用次数: 27
Pub Date : 2004-06-01 DOI: 10.1016/j.cein.2004.10.003
Ros Sanders (Senior Lecturer)
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引用次数: 1
Surgical patient education: assessing the interventions and exploring the outcomes from experimental and quasiexperimental studies from 1990 to 2003 外科病人教育:评估干预措施并探讨1990年至2003年实验和准实验研究的结果
Pub Date : 2004-06-01 DOI: 10.1016/j.cein.2004.09.002
Kirsi Johansson, Sanna Salanterä, Katja Heikkinen, Anne Kuusisto, Heli Virtanen, Helena Leino-Kilpi

Objectives

To assess surgical patient education interventions and to explore the outcomes of experimental and quasiexperimental studies from 1990 to 2003.

Design

Systematic literature review.

Material and methods

Database searches were carried out in May and September 2003 on Medline and Cochrane Library files from 1990 to 2003, using the inclusion criteria of adult surgical patients, patient education in experimental and quasiexperimental studies, English language and nursing. Data analysis in September–October 2003 focused on assessing the interventions and the outcomes of the studies.

Main results

The database search yielded 32 articles involving 2723 participants. Most of the interventions concerned preoperative surgical patient education and focused on cardiological patients. The most common outcome measures were experiential related (87.5%) and cognitive related (59%). None of the studies measured social or ethical aspects of patient education. Half of the studies (50%) reported both statistically significant and non-significant outcomes. There were also a number of studies (41%) which reported no statistically significant findings.

Conclusions

Educational interventions may have many positive effects, but it is difficult unequivocally to demonstrate those effects. This review did produce some evidence on the effectiveness of patient education, but more rigorous research with strict intervention designs and measures is still needed.

目的评价1990 ~ 2003年外科患者教育干预措施,探讨实验和准实验研究的结果。系统文献综述。资料与方法于2003年5月和9月对Medline和Cochrane图书馆1990 - 2003年的文献进行数据库检索,纳入标准为成人外科患者、实验和准实验研究中的患者教育、英语语言和护理。2003年9月至10月的数据分析侧重于评估干预措施和研究结果。数据库检索得到32篇文章,涉及2723名参与者。大多数干预措施涉及术前患者教育,并侧重于心脏病患者。最常见的结果测量是经验相关(87.5%)和认知相关(59%)。没有一项研究衡量患者教育的社会或伦理方面。一半的研究(50%)报告了有统计学意义和无统计学意义的结果。也有一些研究(41%)没有报告统计学上显著的发现。结论教育干预可能有许多积极作用,但很难明确地证明这些作用。这篇综述确实为患者教育的有效性提供了一些证据,但仍需要更严格的研究和严格的干预设计和措施。
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引用次数: 42
期刊
Clinical effectiveness in nursing
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