Research in nursing & health
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Randomized Controlled Trial Clinical Trial
Stress-point intervention for parents of repeatedly hospitalized children with chronic conditions.
Little is known about how to assist children with chronic conditions and their families cope with repeated hospitalizations. A two-group, pretest-posttest study was done to determine whether a community-based, stress-point nursing intervention for parents could decrease distress and improve child and family functioning. Fifty participants were randomly assigned to intervention or usual care control groups. ⋯ There were no child behavior differences between the groups after hospitalization. Intervention children had no developmental regression at 2 weeks and better developmental gains 3 months after discharge than the usual care children. Stress-point intervention for families and their children with chronic conditions improved family coping and functioning, and eliminated hospitalization-induced developmental regression.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Helping mothers cope with a critically ill child: a pilot test of the COPE intervention.
The purpose of this study was to pilot test the effects of a theoretically driven intervention program (COPE = Creating Opportunities for Parent Empowerment) on the coping outcomes of critically ill children and their mothers. Thirty mothers of 1- to 6-year-old children in a pediatric intensive care unit (PICU) were randomly assigned to receive COPE or a comparison program. Mothers who received the COPE program: (a) provided more support to their children during intrusive procedures; (b) provided more emotional support to their children; (c) reported less negative mood state and less parental stress related to their children's emotions and behaviors; and (d) reported fewer post-traumatic stress symptoms and less parental role change four weeks following hospitalization. Results indicate the need to educate parents regarding their children's responses as they recover from critical illness and how they can assist their children in coping with the stressful experience.
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The purpose of this study was to examine the health service utilization patterns of elderly male and female enrollees of a large urban staff model Health Maintenance Organization (HMO). This HMO offered a wide spectrum of managed care services for its beneficiaries. A cross-sectional design was employed. ⋯ Three utilization patterns indicated that there were (a) nonsignificant relationships between age or gender and urgent care visits, prescribed pharmaceuticals, and out-of-pocket costs for pharmaceuticals; (b) linear relationships between age and gender and visits to HMO primary care providers (-), home-health care visits (+), emergency care visits (+), hospitalizations (+), and MD visits during hospitalizations (+); and (c) age was curvilinearly related to use of both HMO specialists and non-HMO specialists. These findings suggest that use of acute care services, including hospitalizations, inpatient physician visits, and emergency services increase with age but the use of primary care providers decreases with age. Gender was not a significant modifier of the relationship between age and utilization.
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The purposes of this study were to explore the coping strategies used by patients with chronic low back pain, to test hypothesized mediators of the relationship between self-efficacy and pain outcomes, and to determine the roles of self-efficacy and outcome expectancies in coping with pain in patients (N = 85) with chronic low back pain. The most common coping behaviors were reporting pain, using pain medications, and coping self-statements. Patients' self-efficacy to cope with pain was inversely correlated with pain intensity. ⋯ Perseverance of coping effort was found to mediate the effects of self-efficacy on pain outcomes; however, level of distress was not found to be a mediator. Outcome expectancies were positively correlated with perseverance of coping effort. These findings are discussed in terms of implications for practice and directions for future research.
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Patients receiving curative treatment for cancer have concerns about reporting pain and using analgesics. These concerns are associated with underutilization of analgesics. ⋯ There was no correlation between caregiver and patient concerns and means for the two groups were similar, indicating that within a given dyad either the patient or the caregiver may have greater concerns. The findings highlight the need for patient and caregiver education about reporting pain and using analgesics.