Research in nursing & health
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The purpose of this evaluation was to study the relationship of nurse care coordination (NCC) to the costs of Medicare and Medicaid in a community-based care program called Missouri Care Options (MCO). A retrospective cohort design was used comparing 57 MCO clients with NCC to 80 MCO clients without NCC. ⋯ Fixed effects analysis was used to estimate the relationship of the NCC intervention to costs. Controlling for high resource use on admission, monthly Medicare costs were lower ($686) in the 12 months of NCC intervention (p = .04) while Medicaid costs were higher ($203; p = .03) for the NCC group when compared to the costs of MCO group.
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Randomized Controlled Trial
Additional evidence for the affective dimension of dyspnea in patients with COPD.
The primary purpose of this secondary analysis was to determine whether 103 participants with chronic obstructive pulmonary disease rated the affective dimension of dyspnea (dyspnea-related anxiety and dyspnea-related distress) separately from the sensory dimension (intensity) during baseline exercise testing conducted as part of a randomized clinical trial. A secondary purpose was to determine if dyspnea-related anxiety and distress were rated distinctly different from other measurements of anxiety. At the end of a 6-minute walk and an incremental treadmill test, participant ratings of the magnitude of dyspnea-related anxiety and distress on the Modified Borg Scale were significantly different from their ratings of the intensity of dyspnea. Dyspnea-related anxiety and distress also appeared to be concepts independent from measures of state anxiety, negative affect, and anxiety before a treadmill test.
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In this article, we illustrate a new method for random selection and random assignment that we developed in a pilot study for a randomized clinical trial. The randomization database is supported by a commonly available spreadsheet. ⋯ Advantages of this method are that it is easy to use, effective, and portable, allowing it to be shared among multiple investigators at multiple study sites. Clinical researchers may find the method useful for research projects that are pilot studies or conducted with limited funding.
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Pediatric nurses are not administering available and recommended analgesics to hospitalized children after surgery. This descriptive study was conducted to examine 30 pediatric nurses' thinking-in response to case study vignettes-about pain assessment and morphine administration for children experiencing postoperative pain. ⋯ Nurses demonstrated misconceptions about pharmacokinetics and unwarranted concerns about the adverse effects of morphine. These findings partly explain why children continue to report high levels of pain after surgery and why nurses may not administer adequate analgesics to relieve children's pain.
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Although researchers have identified beneficial coping strategies for cancer patients, existing coping measures do not capture the preferred coping strategies of older African American cancer survivors. A new measure, the Ways of Helping Questionnaire (WHQ), was evaluated with 385 African American cancer survivors. ⋯ Evidence regarding hypothesized relationships with measures of well-being and another coping measure was mixed. The WHQ's content coverage makes it especially relevant for older African American cancer survivors.