Research in nursing & health
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Comparative Study
An application of hierarchical linear models to longitudinal studies.
Nursing researchers are increasingly interested in studying changes in patients' outcomes, such as physiologic and psychological status, across time. The most frequently used approaches, univariate repeated measures, multivariate repeated measures, and pre- and posttest differences, have restrictive assumptions and unrealistic data requirements. ⋯ Hierarchical linear models (HLM) can be used to solve these problems. The advantages of HLM are (a) it describes each individual's growth trajectory and its relationship with initial status, (b) it is not restricted by unrealistic assumptions, (c) if solves the commonly observed problems of missing data, (d) it does not require fixed time intervals, and (e) it provides more precise estimation.
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Comparative Study
The meaning of survival: the early aftermath of a near-death experience.
An estimated 9 million adults in this country may have had a near-death experience (NDE), yet little research has been focused on the early aftermath of this extraordinary phenomenon. The purpose of this interpretive study was to appropriate and make visible how patients who had an NDE during a cardiac or respiratory arrest understood and experienced this early period of survival. Gadamerian hermeneutics (1975/1990) informed and guided the study. This interpretation demonstrates that NDEs and their early aftermath can be the positive, life-enhancing experiences that the common lore and most research tend to depict, yet they can also be unpleasant and distressing experiences fraught with emotional pain and angst.
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The relationship between operating room (OR) table surfaces and skin integrity was examined. Preoperatively, patients (N = 505) were rated for pressure sore potential (Hemphill); postoperatively, skin condition was assessed. ⋯ Factors predictive of pressure sore development included surgery of 2.5+ hr, 40+ years, vascular disease, and a preoperative Hemphill value of 4+. Patient characteristics, surgical experience variables, and OR table surfaces are determinants in pressure sore development.
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The relationship between perceived control over pain and outcomes of distress and disability were studied in a sample consisting of 71 patients with chronic nonmalignant pain. The pain-related control belief subscales measured three aspects of control: lack of control, ability to cope, and negative outcome expectancy. After controlling for pain intensity, the control belief subscales explained a significant amount of the variance in distress and disability. These findings provide support for cognitive modulation of the distress and disability associated with chronic nonmalignant pain.