Behaviors of very preterm neonates as documented using NIDCAP observations.

PURPOSE: The purpose of this study was to describe the range and frequency of behaviors in neonates 24-30 weeks postconceptional age (PCA) using the Newborn Individualized Developmental Care Assessment Program (NIDCAP). DESIGN: A prospective design with convenience sampling was used. SAMPLE: Starting 24-72 hours postnatally and continuing through 30 weeks PCA, 8,144 two-minute observations of 85 NIDCAP behaviors were collected and analyzed from 42 neonates born at 24-29 weeks gestation. MAIN OUTCOME VARIABLE: The main outcome variables were the frequencies of the 85 neonatal behaviors measured by the NIDCAP. Frequencies were organized first by subsystem (autonomic, motor, or state) and were categorized further based on week of PCA. Comparisons of behavioral frequencies by number of weeks PCA were completed using correlation and regression analyses. RESULTS: The most frequently observed behaviors were irregular respirations, pink color, postured flexion of the extremities, immature light sleep, and drowsiness. Least frequently observed behaviors consisted of burps, bowel movement, grunting, smooth motor movements, cooing, and speech movement. Regression analysis illustrated that the pattern of behavior was significantly similar week to week.

Mundanatories no more.

Mandated educational programs are often a source of dread for instructor and participant alike. The nurse educator, the Clinical Nurse Specialist for Intravenous (i.v.) Therapy and Nutritional Support, and the Clinical Program Manager for i.v. Therapy devised a self-paced program to validate the competence of Licensed Practical Nurses (LPNs) in caring for patients receiving i.v. therapy. The program consisted of learning stations which utilized a variety of formats to satisfy the objectives of the program. The LPN could see, hear about, read about, and ask questions related to i.v. therapy. Participants could take as much or as little time as was needed to review the stations. Documentation of competence was the completed quiz which became part of the LPN's personnel file. As an added incentive, the returned quiz was also used as an entry form to win door prizes. Compliance for the program was about 71%. Areas for improvement were identified. Feedback concerning the program from participants and planning team alike was very positive.

Geriatric oncology. Medical and psychosocial perspectives.

PURPOSE: The authors aim to promote cancer control in the older person through an understanding of medical and psychosocial issues related to early detection, evaluation, and management of care. OVERVIEW: The management of cancer in the older adult is an increasingly common aspect of oncologic practice. Over the next decades, special concerns will be generated by the rapid rise in the number and proportion of older persons in our society. This article addresses the following: the identification of those patients who would benefit from interventions; the need for individualized treatment plans and a multidisciplinary approach; factors affecting incidence, clinical course, and treatment of cancer, barriers to cancer screening and treatment; psychological adjustment to cancer; and the medical and psychosocial management of the older person with cancer. CLINICAL IMPLICATIONS: Cancer control in the older person may be improved by removal of the barriers to appropriate screening and by individual treatment plans focused on the special needs of individual patients. The Comprehensive Geriatric Assessment allows adequate appraisal of functional status, comorbidity, life expectancy, quality of life, and economic and emotional needs of individual patients. Treatment strategies based on a global evaluation of the older person are more likely to be successful in terms of compliance and effectiveness.

A closer look at social support as a moderator of stress in breast cancer.

This study explored the effects of perceived social support from friends, family, and spouses on the psychological adjustment of 135 newly diagnosed breast cancer patients. Initial data analyses revealed moderate correlations between greater psychological distress and lower levels of social support. However, when the personality variable of social desirability was controlled for, the relationship between social support and well-being were substantially weakened or eliminated. It is concluded that characteristics of the person, rather than of the situation, underlie the apparent relationship between social support and adjustment to illness. Social workers are advised to make in-depth assessments of ego strengths and past psychological functioning as better predictors of patient adaptation to disease.