Psychosocial treatment for recurrent genital herpes.

Thirty-one individuals with recurrent genital herpes were randomly assigned to one of three conditions: psychosocial intervention, social support, or waiting-list control. Each treatment condition contained two 5-member groups, and the waiting-list condition contained 11 members. Six consecutive weekly 90-min group treatment sessions were conducted for subjects in the first two conditions, whereas those in the waiting-list control condition were offered treatment at follow-up. Subjects in psychosocial intervention were provided with herpes simplex virus (HSV) information, relaxation training, stress management instructions, and an imagery technique. The social support groups shared feelings and experiences about the disease and served as placebo control subjects. Individuals receiving psychosocial intervention reported significantly greater reductions in herpes activity and significant improvements on emotional distress, social support, and cognitive measures when compared with the other individuals. It was concluded that psychosocial intervention effectively reduced the chronicity of recurrent HSV infections and facilitated adjustment to the disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Providing palliative care to older adults: context and challenges

This paper presents the findings of a study aimed at understanding more fully the work of nurses who provide care to older adults who are dying at home. The method employed was qualitative in nature and involved the use of focus groups for data collection. Data were gathered from a total of 40 community-based nurses during four sessions lasting approximately two hours each. Analysis revealed that the provision of care occurred within a context of aging and dying characterized by clients' awareness of impending death, the presence of multiple pathologies, diminishing social support, and a lack of control. Challenges to providing care stemmed from an ethic of high expectation and a health care system experienced as fragmented, bureaucratic, and driven by cost efficiency. Challenges included working in isolation, achieving closure, securing personal support, working collaboratively with others, and keeping up to date. Findings from this study have implications for both education and practice.     

The role of reactive nitrogen intermediates in modulation of gametocyte infectivity of rodent malaria parasites

Two hundred and fourteen young women received acquired immunodeficiency syndrome (AIDS) prevention interventions at an inner-city family health center serving minority patients predominantly. The community in which the health center is located has a high incidence of intravenous (IV) drug abuse. Either a peer or a health care provider delivered the intervention. In the peer-delivered intervention, a trained peer educator reviewed with patients an AIDS "Rap" videotape and several AIDS brochures, which imparted information about human immunodeficiency virus (HIV), its transmission, and prevention. In the provider-delivered intervention, family practice residents, attending physicians, and nurse practitioners used a patient-centered counseling approach to convey the same information. Questionnaires administered immediately before and after the intervention and at one month follow-up evaluated changes in knowledge, attitudes, and behavior. Analyses of data from both combined intervention groups revealed significant improvements in several areas of knowledge, including the effectiveness of using a condom and cleaning IV drug implements with bleach to prevent transmission of HIV. Many improvements were retained at the one-month follow-up. In addition, subjects in both groups who were sexually active stated immediately after the intervention that asking a sexual partner about past sexual experience would now be less difficult, and at one-month follow-up they reported a significant decrease in the frequency of vaginal sex. Our findings suggest that counseling by physicians can achieve more changes in knowledge of sexual risks, whereas peer education can achieve greater changes in knowledge about IV drug use. Results show that both approaches to AIDS prevention used in this study can significantly affect knowledge, attitudes, and sexual behavior.     

A randomized control trial examining the effect of acceptance and commitment training on clinician willingness to use evidence-based pharmacotherapy.

This study evaluated the effectiveness of acceptance and commitment training (ACT) for increasing drug and alcohol counselors' willingness to use evidence-based agonist and antagonist pharmacotherapy. Fifty-nine drug and alcohol counselors were randomly assigned to either a 1-day ACT workshop or a 1-day educational control workshop. Both groups then attended a 2-day workshop on empirically supported treatments for substance abuse. Measures were taken at pre- and posttraining and 3-month follow-up on reported use of pharmacotherapy, willingness to use pharmacotherapy, perceived barriers to implementing new treatments, and general acceptance. As compared with those in the education alone condition, participants in the ACT condition showed significantly higher rates of referrals to pharmacotherapy at follow-up, rated barriers to learning new treatments as less believable at posttraining and follow-up, and showed greater psychological flexibility at posttraining and follow-up. Mediational analyses indicated that reduced believability of barriers and greater psychological flexibility mediated the impact of the intervention. Results support the idea that acceptance-based interventions may be helpful in addressing the psychological factors related to poor adoption of evidence-based treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An assessment of two training interventions designed to increase the knowledge of obstetrical nurses and nurse-midwives about the maternal serum triple screen

The purpose of this study was to assess the effects of two brief training interventions designed to improve nurses' and nurse-midwives' knowledge about the maternal serum triple screen. The low intervention consisted of written information on the triple screen; the high intervention consisted of written information plus a one hour oral presentation. Knowledge was assessed at baseline, immediately following the oral presentation (high intervention only), and one month following the interventions. Forty-seven nurses, nurse-midwives and nursing assistants participated. Sixteen respondents (34 per cent) who routinely talk to patients about the triple screen obtained a score of less than 70 per cent on the knowledge questionnaire at baseline assessment. Respondents' knowledge about the maternal serum triple screen included areas that needed to be improved in order for them to be able to provide patients with accurate and complete information. Both interventions assessed in this study resulted in an increase in participants' knowledge about the maternal serum triple screen, however the high intervention was more effective. This study presents evidence that improvements in health care professionals' knowledge can be made with brief educational interventions.     

Early intervention for parents at risk of child abuse and neglect: A preliminary investigation.

An early intervention program for young parents and children who have been identified as being at risk of child maltreatment was evaluated. Thirty mother–child dyads were randomly assigned to one of two conditions: (a) an information group offered by the child protection agency (which served as a control condition) or (b) a special program of behavioral parent training in addition to the agency group. Self-report measures indicated that significant improvements in parenting risk and child behavior problems at posttest and at 3-month follow-up were evident only for mothers who received parent training in addition to information groups. Home observation data were inconclusive, possibly due to the limited opportunities to observe behaviors of interest. Both groups showed improvements in their child-rearing environments and in their children's adaptive behaviors at follow-up. Caseworker ratings of clients' risks of maltreatment and abilities to manage their families at 1-year follow-up significantly favored the families who received parent training in addition to information. Methodological and treatment issues arising from this preliminary investigation of early intervention with diverse population of high-risk parents and children are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification, intervention and education: essential curriculum components for chemical dependency in nurses

BACKGROUND: A documented need exists for continuing education in the area of chemical dependency as it relates not only to patient care, but also to nurses who are susceptible to addiction. This is significant due to the fact that nurses are at risk for chemical dependency and many nurse peers are unable to recognize the signs of chemical dependency and therefore unable to actively intervene. CONCLUSION: According to the literature, which includes current research, nurses lack knowledge regarding specific risk factors, symptoms of chemical dependency in peers, and steps for intervention. In addition, the literature revealed that nursing curricula allot little time to chemical dependency issues. The results of a small-scale learning needs assessment support this literature finding. Continuing education courses can effectively educate nurses to be able to identify their own susceptibility and those of chemically dependent peers, intervene appropriately, and begin the healing process for the impaired nurse. This article outlines a curriculum and additional resources to address the learning needs of nurses related to chemical dependency.     

Second malignancies in cervical cancer patients in the west of Scotland

A recent focus in health care is to develop a seamless transition for patients between the variety of health care agencies with whom they interact. The continuum of care for patients with stroke is complex and many levels of care are required, from acute intervention through to rehabilitation and reintegration into the community. A group of nurses from a variety of agencies in Southwestern Ontario received funding from the Ontario province Wide Nursing Project to effect a desirable change in the way nurses care for the stroke patient. This article describes the Ontario Province Wide Nursing project and the process of and challenges in developing a nursing model for stroke. The development of a nursing model for stroke patients and their families involved conducting nursing, and patient and family focus groups to identify key issues. Thirty-eight nurses participated in the nursing focus groups, and 8 patients and 18 family members participated in the patient and family focus groups. The common themes were the need for improved communication and the need to better prepare patients and families for the many transitions they experience during their recovery from stroke. A Stroke Education Record, which identifies a comprehensive list of potential learning needs of stroke patients and their families, and a Stroke Education and Resource Guide, which provides a reference for nurses, were developed and will be implemented in September 1998. Implementation of the model included a workshop, staff inservices, a self-learning package, and unit displays. Evaluation of the model will include nursing and patient and family focus groups, a chart review, written nursing evaluations, and patient and family telephone interviews.     

Validation of the U.K. diagnostic criteria for atopic dermatitis in a population setting. U.K. Diagnostic Criteria for Atopic Dermatitis Working Party

Alterations in sexual health caused by inflammatory bowel disease (IBD) may affect quality of life and disease status. IBD usually strikes adolescents or young adults, who are also facing developmental milestones important to sexual health. Issues include growth and development, body image, intimacy and sexual functioning, fertility, and pregnancy. A review of published research regarding these issues, in addition to suggestions for nursing assessment and interventions, is included in this article. Nurses must offer sensitive support and suggestions for coping. Nurses must be aware of the issues influencing sexual health when providing total care to clients with IBD.     

Substance abuse education for clinical nurses: a controlled study

BACKGROUND: A study was conducted to evaluate a substance abuse component of a workshop for nurses being promoted to the position of Advanced Clinical Nurse. METHODS: We compared whether the 88 nurses who received the educational intervention increased their knowledge and enhanced their feelings of competence regarding the care of chemically dependent patients more than a control group of nurses who received the promotion workshop without the substance abuse component. RESULTS: The nurses in the intervention group had greater increases in knowledge and competence. CONCLUSIONS: This study points out the importance of providing hospital nurses with continuing education on substance abuse to compensate for their educational deficiencies, to provide the information they need and desire, and to help them meet the ANA's practice standards.     

Graduate nursing education: developmental disabilities and special health care needs

As children and adults with developmental disabilities and special health care needs are integrated into home, school, and community life, nurses are being required to provide leadership, advocacy, and training in community settings to a much greater extent than in the past. To assess the school and community need for formal graduate preparation for nurses who work with individuals with developmental disabilities and/or special health care needs, 25 nurses in leadership positions representing urban and rural health agencies throughout Minnesota took part in a 5-hour focus group discussion. Analysis of data summarized from this process shows five features of the recommended curriculum necessary for advanced practitioners in this specialty area: (a) discipline-specific core competencies, (b) discipline-specific specialty competencies, (c) genetic competencies not specific to nursing but necessary to function in nursing roles, (d) interdisciplinary and intradisciplinary learning experiences, and (e) clinical experiences with preceptors. The authors recommend the development of interdisciplinary graduate programs designed to prepare nurses to assume leadership roles in school health, public health, home health care, and systems management that will affect public policy and, ultimately, promote change in the systems charged with responsibility to serve this population.     

Forms and methods of tutorship in the university nursing diploma. Consensus conference in San Miniato, November 1997)

The contribution presented is the result of a workshop with the participation of nurses, educationalists and course directors involved in the education of student nurses. The different educational experiences and organizational styles adopted in nursing schools were compared and some reflections on the role and expected competences of the nurse tutor, responsible of the theoretical and practical training of student nurses are formulated. The consensus document analyzes the implications related to the different definitions of the role of the nurse-tutor and each different role is discussed according to the theoretical model it derives from. Different educational strategies are discussed and eventually proposals on the education and educational requirements of the nurse-tutor are made.     

The relationship among genital herpes simplex virus, stress, and social support.

Examined the role of stress in activation of genital herpes simplex virus (HSV) lesions, as mediated by social support, in 59 adults who had self-reported culture-positive genital HSV for at least 10 mo. Retrospective reports of HSV symptoms revealed that duration of disease and herpes-specific social support were significant moderators of the relation between stress and number of HSV recurrences (HSV-R) in the preceding 12 mo. When duration of disease was short (     

A 9-year longitudinal study of reported oral problems and dental and periodontal status in 70- and 79-year-old city cohorts in northern Sweden

BACKGROUND: From 1991 to 1994, a special projects grant to teach nurses cancer prevention/screening theory and clinical skills was developed, implemented, and evaluated. Approximately 60 nurses in Colorado rural settings attended five two-day training sessions over a 20-month period. Attitudes, constructive or destructive, regarding specific behaviors lead to intentions to perform those behaviors and have an important impact on cancer-related nursing practice. METHODS: Two cancer-related attitude scales, Cancer Prevention/Early Detection Attitude Inventory and Fanslow Cancer Attitudes Scale, were administered prior to the first training session, following the final session, and at six-month follow-up. Data reflecting program impact on nursing practice were obtained from follow-up self-assessment of confidence in implementing new knowledge and skills. RESULTS: Significant differences in pre- and post-training attitude scores and fairly high-level confidence ratings suggest that these nurses will continue to use their cancer prevention and detection skills in practice. CONCLUSION: Documentation of practice activities to date has been impressive.     

Sharing our world: perioperative nurses have the vision

1. Perioperative nurses must bridge the information gap and eliminate public misconceptions about surgery and OR nursing. Fear of the unknown realm of surgery and televised inaccuracies about surgical procedures magnify the lack of awareness of health care consumers about surgery and the holistic nursing care perioperative nurses provide for their patients. 2. There is a national need for more aggressive general promotion of health care awareness and education. This need can be successfully facilitated at the grassroots level with minimal efforts from members of our surgical departments. 3. One effective way to solve this problem is to invite health care consumers into our facilities.     

Management of gap non-union of tibia by tibialisation of ipsilateral vascular fibula

Community health, psychiatric, and pediatric nurses who work with young children and their families often assess the family's sleep and rest patterns, especially in relation to children's sleep disturbances. Nurses have traditionally taken a rigid approach on this issue that excludes culturally diverse options. The author uses examples from her own nursing education and from cross-cultural research to demonstrate the cultural bias favoring separation of child from parent. The article explores options for broadening nurses' assessment of family sleeping arrangements and designing interventions that take into consideration culturally diverse values and habits. Implications for nursing practice include greater trust-building and mutual learning.     

Differentiated levels of nursing work force demand

In addition to reviewing the literature about the extent to which basic nursing education is related to actual nursing practice, this article investigates the extent to which the relationship between nursing practice, education, and experience varies across specific health care settings. The literature presented no consistent or systematic association between type and amount of previous nursing experience and current nursing practice. However, the literature generally provided evidence of a consistent and systematic association between baccalaureate preparation and level of registered nurse (RN) practice. The review of practice and organizational differences across the hospital, nursing home, and ambulatory care sectors suggests that baccalaureate-prepared RNs in hospitals may have a more strongly differentiated role relative to those in nursing homes and ambulatory settings. If baccalaureate-prepared nurses continue to be perceived as capable of more complex and independent practice, and if employers believe that they can increase revenues by increasing the quality of nursing care or can save money by shifting to RNs some responsibilities now held by more costly personnel (such as physicians), then demand for baccalaureate-prepared nurses may increase.     

Thirty-month follow-up of drinking moderation training for women: A randomized clinical trial.

This study examined the durability of a group-based drinking moderation training for heavily drinking women reporting low physical dependence on alcohol. A 30-month follow-up of participants was conducted based on a previous study of 144 women randomly assigned to treatment conditions (G. J. Connors & K. S. Walitzer, 2001). Thirty-month follow-up results indicated that women who at baseline were relatively heavier drinkers had significantly greater benefit from the drinking moderation training when exposed to intervention enhancements entailing life skills training and booster sessions. Further, the initial improvements in drinking, relative to baseline levels, did not statistically deteriorate over the 30-month follow-up. The findings support the application of treatment enhancements among women in this population who at baseline are relatively heavier drinkers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assertiveness training from the participants' perspective.

Describes a model for a 7-session assertiveness training workshop that has been used with groups of women in several different mental health settings. Results of follow-up evaluations of 85 Ss who participated in assertiveness training over a 2-yr period are presented. These data indicate an enthusiastic response to the experience and increased assertiveness in interpersonal relationships. Many Ss became more aware of their right to be assertive and more capable of assertiveness in some situations, yet more aware of and dissatisfied with their lack of assertiveness in others. Most wanted a one-session workshop to review and practice their skills or a workshop focused on a specific topic, such as vocational or sexual assertiveness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological investigation of genital herpes recurrence: Prospective assessment of cognitive-behavioral intervention for a chronic physical disorder.

Assessed factors associated with genital herpes and investigated the impact of psychological therapy on 16 patients who received 5 wks of structured discussion or cognitive restructuring (CR) group therapy. Measures of attitude about herpes, global coping, distress, loneliness, health locus of control, and recurrence were administered at pre- and posttreatment and at 3 mo follow-up. Information was extracted from daily self-reports regarding herpes symptoms, dysphoria, anxiety, and ongoing coping. Therapy did not produce expected reductions in distress or loneliness. CR, however, was associated with reduced frequency of lesion recurrence at follow-up. Avoidant coping was associated with lower recurrence rates, and loneliness scores with higher rates. Results show that recurrences were preceded by elevated anxiety independent of prodromal symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)