An examination of critical care nurses' knowledge and attitudes regarding pain management in hospitalized patients.

The purpose of this study was to determine the effectiveness of an educational intervention focused on pain management. The sample consisted of 30 medical/surgical intensive care nurses (age range, 23 to 62 years) employed in a large metropolitan hospital in the southeastern United States. McCaffery and Ferrell's Nurses' Knowledge and Attitude Survey Regarding Pain was administered at 2 points in time: before and after the educational program. The survey simultaneously measures knowledge and attitude levels regarding pain control. The paired t test was used to test for differences between pre- and posttest scores. The Point-biserial and Spearman's correlation coefficients were computed to examine relationships between selected sociodemographic variables and scores (baseline and change) on the survey. Results revealed a significant increase in scores after the educational intervention (t = 9.60. p = .0005). Additionally, a statistically significant correlation was found between change scores (posttest minus pretest scores) and years of nursing experience (rs = .37, p = .047). However, no significant relationships were found between type of nursing degree and baseline or change scores (rpb = .11, p = .575; rpb = .01, p = .955). These results support previous research findings related to the problem of inadequate pain management in the hospital setting. Further, the findings indicate that education regarding pain control is crucial for current nursing students as well as practicing nurses. The challenge for nurses is to be responsive to and integrate current pain management techniques in an effort to decrease the discomfort of hospitalized patients.

The status of injury in upstate South Carolina.

In conclusion, injuries are a leading cause of emergency room visits and hospital admissions in the upstate of South Carolina. Age was a major factor in the type of injury risk, hospitalization and, once hospitalized, length of stay and cost of hospital care. Future research efforts should include both quantitative and qualitative approaches to develop a more precise profile of persons who are most at risk for injury due to falls, motor vehicle crashes and intentional injuries. Information is also needed on follow-up care, including the cost of care post-hospital discharge and after discharge from the emergency room. The recommendations offered in this report may provide health care providers and health care agencies in the four-county upstate region with a guide to begin examining the major types of injuries that occur within their respective communities. Moreover, populations that are disproportionately affected may be delineated, and interventions may be specifically designed for and implemented in partnership with these populations.

Patterns of breast, cervical, colorectal, and prostate cancer in the Appalachian region of South Carolina.

OBJECTIVES: This study examined the relationship between demographic factors and other correlates of late stage diagnoses among residents in the Appalachian region of South Carolina. DESIGN: The study employed a cross-sectional study design. METHODS: Regional data from 4,928 prostate, breast, cervical, and colorectal cancer registry cases were examined as part of a statewide pilot registry effort. Frequencies and logistic regression procedures were performed to compute risk estimates for non-local stage of diagnosis across all four cancers, and for each of the four cancers by age and race. RESULTS: African Americans were 1.6 times more likely than Whites to be diagnosed with a non-local stage of cancer. For breast and prostate cancer, those 65 and older were significantly more likely to receive non-local state stage of diagnosis than those under 50. For cervical cancer, the odds of receiving a non-local stage diagnosis declined with advancing age, with those over 65 being significantly less likely than those under 50 to receive non-local stage diagnoses. CONCLUSIONS: It is necessary to identify sub-populations experiencing high rates of non-local stage diagnoses of cancer to form the basis for the development of more effective cancer prevention and treatment programs.

Importance of fatalism in understanding mammography screening in rural elderly women.

This study examined the relationship between demographic factors and other correlates of fatalism, and assessed the impact of fatalistic beliefs on the participation in breast cancer screening in rural women. The subjects were 220 women aged 50 and over recruited from 6 large rural counties in South Carolina. Data were collected using a demographic questionnaire and the revised Powe Fatalism Inventory. Results show significant associations between fatalism and increased age (p = 0.005), race (p = 0.0001), doctor recommendation (p = .0034) and decreased educational level (p = 0.001). Fatalism was associated with noncompliance with mammography screening in univariate analysis among African-American women (OR = .362; 95% CI: 1.11, 11.8). After adjusting for possible confounders (age, education, and doctor recommendation), fatalism was not significantly associated with noncompliance with screening. These results illustrate age, race, and education may be important predictors of fatalism and that fatalism may be one barrier that has previously gone unmeasured and unchallenged in understanding screening behavior in older women.