Nursing research
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient outcomes for the chronically critically ill: special care unit versus intensive care unit.
The purpose of this study was to compare the effects of a low-technology environment of care and a nurse case management case delivery system (special care unit, SCU) with the traditional high-technology environment (ICU) and primary nursing care delivery system on the patient outcomes of length of stay, mortality, readmission, complications, satisfaction, and cost. A sample of 220 chronically critically ill patients were randomly assigned to either the SCU (n = 145) or the ICU (n = 75). Few significant differences were found between the two groups in length of stay, mortality, or complications. ⋯ The average total cost of delivering care was $5,000 less per patient in the SCU than in the traditional ICU. In addition, the cost to produce a survivor was $19,000 less in the SCU. Results from this 4-year clinical trial demonstrate that nurse case managers in a SCU setting can produce patient outcomes equal to or better than those in the traditional ICU care environment for long-term critically ill patients.
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This survey examined the relationships of sexual risk taking to substance use and AIDS knowledge in pregnant adolescents (n = 58) and nonpregnant young mothers (n = 93). Subjects were from predominantly minority backgrounds, were single, and ranged in age from 12 to 20 years (M = 16.64). A number of high-risk behaviors were reported, including substance use during pregnancy and early parenthood, unprotected sexual relations, and multiple (lifetime) sex partners. ⋯ Conversely, young mothers were more likely to have multiple sex partners and less likely to have unprotected sex than were pregnant adolescents. Those with a history of marijuana use were more likely to have had multiple sex partners than were adolescents who had never used this drug. AIDS knowledge was not a significant predictor of high-risk sexual behavior.
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Two formats to enable children and adolescents to report the changing intensity, duration, and pattern of their pain were developed and tested: (a) a dot matrix with intensity markers on the y-axis and time markers on the x-axis and (b) a list of words or word phrases describing the temporal dimension of pain. Analyses of the dot matrix markings revealed six patterns of pain: steady decrease, steady increase, ongoing sharp increases and decreases, stair-step increase and decrease, steady increase and decrease, and constant. The 12 words and phrases described how pain began as well as how the pattern of pain changed over time.
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Meta Analysis
Job satisfaction and turnover among nurses: integrating research findings across studies.
A meta-analytic study investigated the causal relationships among job satisfaction, behavioral intentions, and nurse turnover behavior. A theoretical model was proposed in which behavioral intentions were viewed as a direct antecedent to turnover behavior. ⋯ The results of the modifier analysis suggested that effect sizes are fairly robust to differences in study designs, response rates, and methods of measuring job satisfaction, but the manner in which behavioral intentions were operationalized appeared to moderate the relationship between behavioral intentions and turnover and job satisfaction. Of variables related to nursing job satisfaction, work content and work environment had a stronger relationship with job satisfaction than economic or individual difference variables.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of the effects of jaw relaxation and music on postoperative pain.
This experimental study compared the effects of jaw relaxation and music, individually and combined, on sensory and affective pain following surgery. Abdominal surgical patients (N = 84) were randomly assigned to four groups: relaxation, music, a combination of relaxation and music, and control. Interventions were taught preoperatively and used by subjects during the first ambulation after surgery. ⋯ With preambulatory sensation, distress, narcotic intake, and preoperative anxiety as covariates, the four groups were compared using orthogonal a priori contrasts and analysis of covariance. The interventions were neither effective nor significantly different from one another during ambulation. However, after keeping the taped interventions for 2 postoperative days, 89% of experimental subjects reported them helpful for sensation and distress of pain.