Planning strategies for the avoidance of pitfalls in intervention research.

BACKGROUND: With the exception of large clinical trials, few studies in nursing and other social sciences test interventions. The discipline of nursing needs to maintain a full range of research designs for continued knowledge development. Intervention research presents unique opportunities and challenges for the novice as well as the seasoned researcher. Some of these methodological challenges include the complex nature of human subjects and interventions, including many factors that interfere with the study variables. Preliminary studies often reveal challenges that may not always be predicted or reflected in research texts. These challenges may be as important as the study results for success in future research efforts. PURPOSE: Difficulties encountered in intervention research and suggested strategies for maintaining the integrity of the study are addressed. These challenges include maintaining an adequate sample size, intervention demands, measuring variables, timing issues, and experiencing unexpected events. FINDINGS AND CONCLUSIONS: Strategies presented include the importance of extensive planning, minimizing subject expectations and rewarding efforts, attention to control group members, incorporating retention strategies, expanding knowledge of variables and the study population, preliminary studies as well as anticipating unexpected events. The need for enhanced communication among nurse researchers, educators and clinicians is addressed. In the current health care arena, nurse researchers must understand organizational dynamics and marketing strategies. Collaborative research efforts can increase the visibility of nursing research as well as funding opportunities.

Routine use of ultrasound during pregnancy.

Ultrasound technology offers valuable information when used as a diagnostic tool during a pregnancy at risk for complications. Its use has expanded greatly to uncomplicated pregnancies as a result of expectant parents' desire to see their baby or to know its gender. Many women are having ultrasounds without being given factual information regarding the purposes, risks, and/or benefits of this procedure. Decisions regarding ultrasound sonography could have a significant physical or emotional impact on the pregnancy, and informed decision making can take place only when the patient is properly educated. Issues regarding ultrasound benefits, safety, controversies, and information helpful to nurse practitioners involved in sonography are addressed in this article.

Preplacement evaluation: thriving within the ADA guidelines.

1. The intent of the Americans With Disabilities Act (ADA) is to remove barriers against those with known disabilities and to require reasonable accommodation to enable qualified employees to perform a job. The ADA is not meant to facilitate those with covert preexisting conditions in setting up workers' compensation and disability claims. 2. Essential job functions are physical and mental requirements for a job that are developed by the supervisor and the occupational health department. These functions should be included with the posting of any position. 3. Preplacement evaluation requirements: essential job functions that are used to determine what is included in the assessment; employee capability statement (with reasonable accommodation); and conditional offer of employment pending a satisfactory post-offer evaluation prior to beginning the job.

Effectiveness and cost efficiency of interventions in health promotion.

The effect of a stress management programme as a component of an overall fitness programme was evaluated. Psychological, physiological and economic parameters were examined in relation to stress management activities in an experimental study. Subjects were stratified by life stressors and then randomly assigned to groups. Stress-related physical symptoms decreased significantly (P less than 0.05) in the treatment group. Those who practised the relaxation techniques regularly had significantly lower systolic blood pressure (P less than 0.05). Results of cost evaluation demonstrate the benefits from a programme with relatively low overall costs.

Looking above the bottom line: decisions in economic evaluation.

Economics can be a complex mix of formulae based on data with varying degrees of accuracy and assumptions. A realistic picture of costs and benefits will assist decision making and facilitate more accurate expectations and criteria for success.

Stress management in a military health promotion program: effectiveness and cost efficiency.

An experimental study was conducted to determine the impact of a stress management course within a health promotion program. Assessments were made of stress related symptoms, perception of stress, and blood pressure. Costs of the program per benefit were calculated.

Enhancing publication success.

Because writing for publication is often a solitary and difficult process, a writing support group was formed to encourage and assist prospective authors. In addition to increasing participants' productivity in the publication arena, the group facilitates collaboration between nurses in academia and practice. The quality and quantity of publications increase when the expertise of educators, administrators, and clinicians is combined and their writing efforts are supported.