Variations in feminine hygiene practices of military women in deployed and noncombat environments.

There is limited information on how military women manage feminine hygiene practices in combat and noncombat environments. The purpose of this study was to describe feminine hygiene practices of military women in deployed and noncombat (normal) environments. A nonexperimental descriptive research design was used. The study used a survey questionnaire, the Deployed Female Health Practice Questionnaire, which was developed specifically for military women to report their experiences with hygiene issues. Significant differences between deployed and normal environments were found in the areas of types of menses management products used and in douching and handwashing practices. Continuing education about safe feminine hygiene practices will help military women cope better in deployed (field) environments. Recommendations suggest further study on intervention strategies for hygiene management practices.

Improving qualitative proposals: common problem areas.

Advanced practice nurses conducting clinical research may decide to use qualitative methods. These types of studies also are now receiving more positive consideration for funding than they have in the past. When writing a proposal for research projects, investigators new to qualitative research frequently have misconceptions about this type of research and the assumptions on which the research is based. These misconceptions lead to problems within the proposals that make it difficult for reviewers to evaluate adequately the research plan. In this article, the authors outline problems frequently observed in qualitative proposals, offer advice on how to correct the problems, and provide some examples from their own funded proposals.

The relationship of burnout, stress, and hardiness in nurses in a military medical center: a replicated descriptive study.

The purpose of this descriptive study was to determine whether the personality trait of hardiness is a predictor of burnout and whether it can buffer the effect of stress on burnout. Forty-nine registered nurses working in 7 special care units completed the Tedium Burnout Scale, the Nursing Stress Scale, and the Hardiness Test. Results indicate that burnout, stress, and hardiness had a significant relationship (P < .001). Hierarchical multiple regression analysis indicated that hardiness alone accounted for 35% of burnout variance (P < .05) and that the addition of stress had no effect. A previous study reported that burn unit nurses had the least burnout and greatest hardiness. However, in this study, nurses from the Burn Intensive Care Unit had the highest burnout and stress scores and the lowest hardiness scores of nurses from the 7 units. This study confirms findings by a previous study that hardiness is a predictor of burnout but is not a buffer in the stress-burnout relationship. To further understand burnout and hardiness, longitudinal and multisite studies that include burn units are recommended.

Development of a decision tree for support surfaces: a tool for nursing.

The use of specialty support surfaces can be clinically beneficial for at-risk patients, but can prove costly if their use is not closely monitored. A decision tree can guide health care providers in selecting the most appropriate support surface based on the patient's condition. The process used by one medical center to develop and test a decision tree for specialty support surfaces selection is described.

Costs and outcomes of a military bone marrow transplant program.

There is a lack of published cost and outcome data concerning bone marrow transplant (BMT) patients treated in a military health care setting. The objectives of this prospective investigation were to collect demographic data concerning the characteristics of patients using the service, to track outcomes of length of stay, relapse, and mortality, and to analyze cost data based on a specific cost accounting system that was created to accurately capture individual versus aggregate costs. The sample consisted of 106 patients, 71 adults and 35 children. The mean cost of an adult autologous BMT was $45,600, the mean cost for a pediatric autologous BMT was $60,725, and the mean cost of a pediatric allogeneic BMT was $68,930. Previously, $100,000 to $500,000 per transplant was paid for military beneficiaries receiving BMTs in the civilian sector. Expenditures related to treating adult patients were reduced by $50,000 to $100,000 per patient. Savings associated with each pediatric transplant ranged from $100,000 to $200,000.

Diseases treated with blood cell transplants.

OBJECTIVES: To provide an overview of the vast amount of clinical and research data concerning the diseases treated with blood cell transplants. DATA SOURCES: Research studies, abstracts, book chapters, and articles pertaining to diseases treated with blood cell transplantation (BCT). CONCLUSIONS: The potential for the expanded use of BCT in cancer and other diseases appears unlimited. This type of transplantation is gaining widespread use and the number of centers offering this treatment for hematologic and solid tumors is increasing. IMPLICATIONS FOR NURSING PRACTICE: Nurses working in acute care, outpatient, and home care settings need to familiarize themselves with the rapidly expanding role of this treatment to provide the most state-of-the-art care to their patients.

Expectations and experiences of patients with cancer participating in phase I clinical trials.

PURPOSE/OBJECTIVES: To describe the expectations and experiences of patients entering phase I clinical trials. DESIGN: Descriptive, exploratory, prospective. SETTING: A large military medical teaching center. SAMPLE: Thirty-seven adult patients completed the entry and exit interviews. Subjects had a good performance status, were middle aged, and had common tumor types. METHODS: Interviews using structured entry and exit questionnaires. MAIN RESEARCH VARIABLES: Expectations and experiences of patients in phase I clinical trials. FINDINGS: Patients expected slightly increased support from family members and received more support than expected. Patients' expectations for tumor response and increased communication with their physician were not met. Patients expected symptoms such as fatigue, nausea and vomiting, and weight loss to improve during therapy, yet their expectations were not met. CONCLUSIONS: One theme that emerged from the data was hope/optimism. An issue that needs further exploration is the extent to which patients accurately understand information in the consent form. Findings also support the importance of communication between the patient and family members and the healthcare team. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses can mediate the flow of information between physicians and patients. Oncology nurses can and should assess the patient's level of understanding of the clinical trial, the consent form, and potential side effects at the time of entry into the trial and intermittently during the course of therapy. Nurses must allow patients with cancer who are undergoing investigational therapy to maintain a level of hope, while realistically counseling them about their progress during phase I trial participation.

Staff nurses' career development relationships and self-reports of professionalism, job satisfaction, and intent to stay.

The purpose of this study was to investigate the range of career development relationships (CDRs) experienced by staff nurses in relation to the outcomes of professionalism, job satisfaction, and intent to stay. A sample of 390 Army staff nurses completed questionnaires measuring five CDRs--precepting, peer-strategizing, coaching, sponsoring, and mentoring--and the outcome variables. Findings indicated that 61% of the sample experienced a CDR, with the predominant CDR being coaching. No CDR affected professionalism; however, job satisfaction and intent to stay may warrant further investigation in relation to CDRs. The findings suggest that if nurses perceived that an interest was taken in their career development, and felt valued by the developer, then usually staff nurses viewed the relationship as professionally important. The perception of importance often influenced intent to stay in a positive direction.

A descriptive study of mentoring relationships experienced by Army nurses in head nurse or nursing supervisor roles.

Mentoring relationships experienced by Army Nurse Corps officers in head nurse or nursing supervisor roles were examined via a survey questionnaire. Findings indicate that career development relationships are occurring among these nurses, but less than half of the relationships consist of mentoring. Nursing supervisors comprised the largest group of career developers, while head nurses were the second most likely group to assist with the development of a novice nurse. Approximately half of the nurses indicated that the career development relationship had a "substantial" influence on their personal lives, and a "very great" influence on their professional lives.

The clinical nurse specialist and the media.

The media continually presents messages to the public concerning health care issues and nursing. Unfortunately, much of this information is presented by lay writers who interpret health care research/issues for the public from the medical model and who are naive about the profession of nursing. The clinical nurse specialist (CNS) is a highly skilled clinician who is knowledgeable about health care issues and can assume a leadership role in providing accurate and timely information to the public. The CNS can develop a visible role as a health care educator via the media. This paper will examine the role of the CNS in relation to the media and will present recommendations for dealing with various types of media.

The epidemiology of ovarian cancer: a review.

Ovarian cancer is difficult to detect in an early stage when cure rates are higher. Because of this, it is important to identify women who may have a greater probability of developing the disease. The question of what factors influence a women's chances of developing ovarian cancer continues to be extremely difficult to answer. Nurses who understand the epidemiology of ovarian cancer and who are skilled in taking comprehensive health histories can play a major role in educating women to continue to obtain gynecologic screening exams, even in their postmenopausal years.