Slow stroke back massage: its effect on patients in a rehabilitation setting.

A quasi-experimental design was used to determine the effects of three consecutive days of slow stroke back massage (SSBM) on adult patients in a rehabilitation setting. This study used the Huckstadt Touch Instrument to assess physiological and psychological responses to touch, as well as the recipients' perceptions of touch. The convenience sample comprised 24 adult patients in a rehabilitation hospital in southeastern North Carolina. Subjects' ages ranged between 52 and 88 years with a mean of 71.8 years. There was a significant decrease in systolic and diastolic blood pressure after SSBM on all 3 days. There was a statistically significant decrease in mean heart rate and mean respiratory rate on Days 1 and 3. There was no psychological change in any of the patients. Perception scores, however, indicate a positive response to SSBM. Patients perceived it as being comfortable, good, pleasant, and warm. On all occasions, their responses indicated that the intervention made them feel cared for, happy, physically relaxed, less anxious, calm, restful, and gave them a feeling of closeness with the nurse.

Differences in African American and white women with myocardial infarction: history, presentation, diagnostic methods, and infarction type.

BACKGROUND: Despite overall declining death rates from cardiovascular disease, the number of women dying of cardiovascular disease increases each year, with substantially higher rates in African American women than in white women. OBJECTIVE: To investigate differences in presentation, diagnostic method, and type of infarction between African American and white women with myocardial infarction. METHODS: Chart review of all women with discharge diagnosis of myocardial infarction. RESULTS: No significant differences were found between African American and white women in admitting diagnosis, diagnostic methods, or type of infarction. At the time of admission, 2 medical history variables, stroke and hypertension, differed significantly between African American and white women (P = .027 and P = .002, respectively). CONCLUSIONS: Healthcare professionals must be aware of possible racial differences in medical history, signs and symptoms, and prognosis when assessing patients and planning interventions. Studies with larger samples are needed to confirm these findings on African American and white women with myocardial infarction.

Teaching communication about human sexuality to nurses and other healthcare providers.

Nursing and healthcare professional faculty are challenged to prepare graduates who are comfortable and capable of discussing human sexuality issues and concerns with patients who are victims of family violence, AIDS and other sexually transmitted diseases, rape, and abuse, as well as patients who have undergone cardiac surgery and other life-threatening events. The authors recommend using a holistic approach as the basis for teaching strategies.

African-American caregiving for a relative with Alzheimer's disease.

This study explored the meaning of caregiving to nine African-American caregivers of family members with Alzheimer's disease. Open-ended questions were used. Four major themes emerged from the study: caregiving is a traditional family value, caregiving is an act of love, social support is a mediator of the caregiver burden, and caregiving is a female role.

The effects of inservice education on the institution of triage protocols.

This correlational study examined the effects of inservice education on the initiation of triage protocols by emergency room nurses for patients experiencing cardiac symptom distress. The study used a pretest/posttest design with a convenience sample of 40 patients who were experiencing cardiac symptom distress. Chart reviews were conducted on 20 patients seen in the emergency room with suspected myocardial infarction. Then emergency room nurses had an inservice program on institution of triage protocols, and 20 more patient charts were reviewed. The study revealed two statistically significant findings. First, the staff nurses incorporated pain and symptom distress measurement tools in physical assessments more frequently after inservice education sessions than before inservice education sessions. Second, the staff nurses documented the use of triage protocols more frequently after the inservice education sessions than before the sessions. These findings suggest that nursing inservice education positively affects nursing care for patients with suspected myocardial infarction.

Telephone communications between diabetes clients and nurse educators.

The purpose of this study was to describe the use of telephone communications between diabetes nurse educators (DNEs) and their clients with diabetes. A questionnaire was designed to examine the use of the telephone with diabetes clients from the perspective of DNEs. A total of 465 DNEs across the US were selected using a systematic sample from the membership directory of the American Association of Diabetes Educators. A total of 247 were questionnaires completed and returned (55%). Ninety-one percent of DNEs reported using the phone with clients and averaged 15 phone calls per week. Over 90% frequently reported discussing the following topics with clients: home blood glucose monitoring, hyperglycemia, hypoglycemia, insulin use, and diet. Analysis of telephone users showed that DNE experience and diabetes educator certification were significant factors in the differences observed in the reported topics discussed over the telephone. These findings suggest the need for guidelines for telephone contact with diabetes clients.

Perceived competence and actual level of knowledge of diabetes mellitus among nurses.

Staff nurses were surveyed on their perceived and actual level of knowledge of diabetes mellitus. Staff nurses (n = 32) employed at a rural 62-bed acute care hospital in the southeastern United States constituted a convenience sample. The Diabetes Self-Report Tool was used to assess staff nurses' perceptions of knowledge of diabetes mellitus. Using a Likert-type scale a mean score of 88% was obtained concerning perceived knowledge. The Diabetes Basic Knowledge Test was used to measure the actual level of knowledge of diabetes mellitus. A mean score of 75% was obtained on the Diabetes Basic Knowledge Test. Nurses' perception of knowledge was not related to actual knowledge scores. Study findings raise questions for the nurse involved in staff development concerning the adequacy of nursing competency validation in the area of diabetes management.

Consumer satisfaction with nursing care in a rural community hospital emergency department.

The article describes a study undertaken to assess patient satisfaction with nursing care in a rural hospital emergency department with respect to psychological safety, discharge teaching, information giving, and technical competence. This descriptive research utilized Davis' Consumer Emergency Care Satisfaction Scale to determine the degree to which 52 patients perceived overall satisfaction with nursing care. Findings indicated that patients were satisfied with nursing care. No statistically significant effect of gender or education level on consumer satisfaction or on any subscale was detected, but African American consumers were less satisfied with discharge teaching, which may suggest that discharge teaching should reflect the cultural diversity of consumers presenting to the emergency department. Nursing staff may need to spend more time with rural African American consumers. Staff may need to be inserviced to meet the cultural and educational needs of African Americans.

Accuracy of fingerstick glucose values in shock patients.

BACKGROUND: Fingerstick blood glucose measurement has become widespread in both hospital and prehospital settings. OBJECTIVE: To determine the accuracy of fingerstick blood glucose measurement in patients with poor peripheral perfusion (shock). METHOD: Results obtained during three methods of glucose analysis (fingerstick blood glucose measurement; bedside and laboratory glucose analysis) were examined prospectively on 38 patients from inpatient medical and surgical critical care units or the emergency department of a large tertiary care referral center. RESULTS: The means of the three glucose measurements were significantly different. Univariate analysis of the mean laboratory glucose value versus the mean fingerstick glucose value was significantly different. The mean venipuncture glucose measured by the bedside glucose meter versus the mean venous laboratory glucose was not significantly different. CONCLUSION: These results suggest that fingerstick blood samples should not be used for bedside glucose analysis in patients who may have inadequate tissue perfusion.

Relative satisfaction with nursing care of patients with ostomies.

Nurses and patients engage in an interactive process that is both supportive and educational. The ability of the nurse to communicate with the patient in a manner that the patient perceives as accepting will lead to transaction, goal attainment, effective nursing care, and satisfaction. This study was undertaken to examine the relationship between nurses' perceptions of patients with ostomies and those patients' satisfaction with nursing care. Data were also collected on nurses' confidence in caring for patients with ostomies, the length of time with the patient, and previous experience in caring for patients with new ostomies. Twelve patients with new ostomies and the registered nurses who cared for them on postoperative units at a regional medical center and a community hospital were identified. Reed's 1989 adaptation of Yuker, Block, and Young's 1972 Attitudes Toward Disabled Persons scale was used to obtain the nurse's perceptions of patients with ostomies. The LaMonica-Oberst Patient Satisfaction Scale was used to obtain the ostomy patients' satisfaction with nursing care. No statistically significant relationship was identified between nurses perceptions of patients with ostomies and these patients' satisfaction with care. However, the data suggest that there may be a relationship between higher patient satisfaction scores and three factors: the nurse's confidence in caring for patients with ostomies, the length of the nurse-patient relationship, and the employment of a certified ET nurse in the hospital in which the patient receives nursing care.(ABSTRACT TRUNCATED AT 250 WORDS)