Concept mapping: reducing clinical care plan paperwork and increasing learning.

The author describes how concept maps were used in place of nursing care plans to reduce care planning paperwork in fundamentals and medical-surgical clinical courses in acute care facilities. In addition to less paperwork, clinical concept mapping enhances students' critical thinking skills and clinical reasoning because students and faculty can clearly and succinctly visualize priorities and identify relationships in clinical patient data.

The psychosocial and physiological experiences of patients with an implantable cardioverter defibrillator.

This article describes the relationships between anxiety, self-efficacy, as well as the psychosocial and physiological experiences of patients with an internal cardioverter defibrillator (ICD). Although survival rates with ICDs are impressive, patients experience psychological and physiological responses to their lifesaving devices. Thirty-nine patients completed questionnaires during outpatient clinic visits. Patients' anxiety levels were correlated with fears about ICD malfunction, fear of death, fear of being shocked, loss of control, trouble related to sleeping, inability to concentrate, overprotective family members, and depression. Patients with physical symptoms had higher anxiety levels than those without physical symptoms. There was not a significant relationship between anxiety and discomfort associated with discharge, the number of discharges, or ejection fractions. Low self-efficacy was significantly related to fears about ICD malfunction as well as patients' inability to work, engage in hobbies, and drive a car. Patients with low self-efficacy had more physical symptoms and lower ejection fractions. There were no significant relationships between self-efficacy and frequency of ICD discharge or patients' discomfort during ICD discharge.

Gender differences in the outcomes of participants in home programs compared to those in structured cardiac rehabilitation programs.

This study compared gender differences in outcomes of patients who had had coronary bypass surgery and either attended structured cardiac rehabilitation programs or participated in home programs. The principal advantages related to patients' attending a structured hospital-based outpatient rehabilitation program, compared to a home program, included increased exercise adherence for males and females, increased knowledge about the condition for males, and increased stress control for females. Return to work, self-efficacy, and aspects of self-care such as adherence to a medication regimen and smoking cessation were not significantly different, regardless of type of program, for either sex. In general, females at home fared the worst regarding lifestyle changes, showing decreased exercise adherence, decreased ability to control stress, and no significant increase in knowledge about their medical condition.

Gender differences in cardiac rehabilitation patients.

Gender differences in anxiety, self-efficacy, activity tolerance, and adherence were assessed in 101 patients (80 males, 21 females) with coronary artery disease consecutively admitted to three phase II cardiac rehabilitation centers. The percentage of women in rehabilitation is 20% lower than anticipated based on coronary morbidity data. On admission to rehabilitation, men were significantly better able to tolerate physical activity, were less anxious, and perceived themselves as having greater efficacy in enduring exercise and activities of daily living than women. During the first month of rehabilitation, 24% of males and 33% of females missed 1 week or more of scheduled sessions. There were no significant differences in demographic or diagnostic characteristics between sexes.