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(1 - 15 of 15)
- Title
- PAIN MANAGEMENT IN PATIENTS WITH FIBROMYALGIA.
- Creator
-
Fischer, Linsey, Allred, Kelly, University of Central Florida
- Abstract / Description
-
Fibromyalgia is a chronic widespread pain disorder that can also cause fatigue, depression, sleep disturbances, and cognitive symptoms. Because the etiology of fibromyalgia is unknown, it is difficult to treat. Research shows that medication alone is insufficient to treat the symptoms of fibromyalgia and that complementary therapies are required to fully manage this disorder. The purpose of this research was to determine what complementary therapies patients with fibromyalgia were currently...
Show moreFibromyalgia is a chronic widespread pain disorder that can also cause fatigue, depression, sleep disturbances, and cognitive symptoms. Because the etiology of fibromyalgia is unknown, it is difficult to treat. Research shows that medication alone is insufficient to treat the symptoms of fibromyalgia and that complementary therapies are required to fully manage this disorder. The purpose of this research was to determine what complementary therapies patients with fibromyalgia were currently using. The sample for the survey was taken from fibromyalgia support groups throughout the state of Florida. A total of 15 people diagnosed with fibromyalgia participated in the survey. The most commonly used complementary therapies included diet and relaxation techniques. The therapies that were rarely or never used were hypnotherapy, Tai Chi, and Chi (Qi) Gong. These findings provide evidence to support client education concerning the use of complementary therapies for individuals with fibromyalgia. Research with larger samples is recommended to provide further evidence of the effectiveness of complementary therapies for this patient population.
Show less - Date Issued
- 2017
- Identifier
- CFH2000158, ucf:46002
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000158
- Title
- EFFECTIVENESS OF NONPHARMACOLOGICAL TECHNIQUES FOR PROCEDURAL ANALGESIA IN THE NEONATAL INTENSIVE CARE UNIT.
- Creator
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Flaherty, Lauren, Allred, Kelly, University of Central Florida
- Abstract / Description
-
The purpose of this thesis is to provide a critical analysis of research findings about nonpharmacological techniques used independently of pharmacological techniques to prevent or reduce procedural pain for infants in the neonatal intensive care unit (NICU). A synthesis of the current research related to nonpharmacological pain relief techniques for infants was conducted for this thesis. Nonpharmacological interventions reviewed in this study include: Kangaroo Care, swaddling, facilitated...
Show moreThe purpose of this thesis is to provide a critical analysis of research findings about nonpharmacological techniques used independently of pharmacological techniques to prevent or reduce procedural pain for infants in the neonatal intensive care unit (NICU). A synthesis of the current research related to nonpharmacological pain relief techniques for infants was conducted for this thesis. Nonpharmacological interventions reviewed in this study include: Kangaroo Care, swaddling, facilitated tucking, positioning, music, non-nutritive sucking and sucrose. An interdisciplinary review of the research was performed using the interdisciplinary databases Cumulative Index of Nursing and Allied Health, PubMED, and PsychINFO. Inclusion criteria for this thesis consists of research focused on preterm neonates (born < 37 weeks gestational age) in the neonatal intensive care unit, the use of nonpharmacological interventions for procedural analgesia, peer reviewed articles, and those written in the English language. This study excludes full term neonates due to the significant number of preterm neonates in the NICU. A total of 18 studies were included in this review. All interventions except for positioning show statistically significant evidence to support their use to reduce procedural pain in preterm neonates. Findings of this thesis may promote further studies and exploration into this field. In addition, this thesis establishes the role of the nurse in providing pain relief for infants in the NICU, as well as provide for enhancement of interdisciplinary care amongst other health care providers.
Show less - Date Issued
- 2011
- Identifier
- CFH0003777, ucf:44739
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0003777
- Title
- FACTORS THAT INFLUENCE IMPLEMENTATION OF PAIN MANAGEMENT STRATEGIES IN THE NEONATAL INTENSIVE CARE UNIT.
- Creator
-
Martinez, Geraldine, Allred, Kelly, University of Central Florida
- Abstract / Description
-
In the United States, 10% to 15% of newborns are admitted to the neonatal intensive care unit (NICU). Painful procedures are unavoidable during NICU care; the neonate experiences approximately 12 painful procedures per day. Inconsistent and/or inappropriate pain management in the NICU remains a problem. The purpose of this study is to identify the prevalent factors that influence the implementation of pain management strategies among nurses who work in a NICU setting in a Central Florida...
Show moreIn the United States, 10% to 15% of newborns are admitted to the neonatal intensive care unit (NICU). Painful procedures are unavoidable during NICU care; the neonate experiences approximately 12 painful procedures per day. Inconsistent and/or inappropriate pain management in the NICU remains a problem. The purpose of this study is to identify the prevalent factors that influence the implementation of pain management strategies among nurses who work in a NICU setting in a Central Florida hospital. This study was conducted using a voluntary and anonymous electronic survey. The survey was divided into two sections; the first section designed to describe the sample, and the second section containing a Likert-type scale that assessed the nurses' general pain knowledge, knowledge of pain assessment, and awareness of accepted pain management strategies. The survey was adapted from previously published research. Results indicate pain was more likely to be addressed when nurses collaborated closely with the attending physician. The majority of nurses were aware of current protocols for pain management on the unit but not all nurses agreed those protocols were adequate. Results also indicated pain assessment education is being provided in the NICU and the nurses feel confident in their skills to assess pain, however, not all nurses agreed that pain is being well managed in their unit. There appears to be a gap between the nurse's knowledge/skill to assess pain and implementation of strategies to decrease pain. Although it is the nurse's responsibility to prevent and treat newborn pain in the NICU, not all nurses agreed that newborn pain is well managed in their unit and some believe pain to be an unavoidable experience in the NICU. Nurse-physician collaboration is key to evidence based newborn pain management.
Show less - Date Issued
- 2014
- Identifier
- CFH0004609, ucf:45271
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004609
- Title
- RECOGNIZING PAIN USING NOVEL SIMULATION TECHNOLOGY.
- Creator
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Grace, Justin C, Allred, Kelly, University of Central Florida
- Abstract / Description
-
Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique...
Show moreEffective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation technology is unable to display emotion, pain, or any facial expression. This limits training and education of conditions that may partially rely on the identification of symptoms based on the alteration of facial appearance, such as pain or stroke. This research explored student nurses� perception of new technology that displayed computer-generated faces, each expressing varying degrees of physical expressions of pain. A total of 15 nursing students participated in the study. Students were asked to interpret the level of pain in four sequential faces using a numeric rating scale of 0-10, with 0 indicating no pain, and 10 the most severe pain possible. After scoring the faces, students were asked to answer four open-ended questions addressing the technology. Results of the study indicate a majority of nursing students believe the technology should be implemented into nursing curriculum and interacting with the projected faces was more beneficial than traditional teaching methods. Eventually, the potential for increased identification of conditions requiring observation of subtle facial changes will be explored.
Show less - Date Issued
- 2016
- Identifier
- CFH2000002, ucf:45569
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000002
- Title
- DOSING ACCURACY WHEN ADMINISTERING ORAL MEDICATIONS.
- Creator
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Hughes, Chelsea, Allred, Kelly, University of Central Florida
- Abstract / Description
-
Inaccurate dosing of children's liquid medication is a major problem that causes adverse effects for children every year. In order to prevent these errors, education for at risk parents is essential. A survey and observational study was done in order to identify parents/caregivers who make dosing errors when measuring out liquid medication for their children. A total of 25 parents/caregivers with children admitted to Arnold Palmer Hospital were included in this study. Study participants...
Show moreInaccurate dosing of children's liquid medication is a major problem that causes adverse effects for children every year. In order to prevent these errors, education for at risk parents is essential. A survey and observational study was done in order to identify parents/caregivers who make dosing errors when measuring out liquid medication for their children. A total of 25 parents/caregivers with children admitted to Arnold Palmer Hospital were included in this study. Study participants completed a survey that included demographic data as well as parenting experience. The parents were directly observed measuring a dose of corn syrup using Children's liquid Tylenol� dosing instructions. The research participants were offered a variety of common measuring devices and they chose the one they most often used at home. Data indicated a high incidence of dosing errors made by a variety of participants. Of the 25 research participants, 13 (52%) made an error greater than 20% when measuring out the dose based on the provided instructions and their child's weight. This data suggests nurses need to include dosing education for all parents at discharge. This study has shown that many parents are at risk for making errors when measuring medication. Effective discharge education on the importance of measuring medication accurately can prevent these errors and the adverse effects they cause.
Show less - Date Issued
- 2016
- Identifier
- CFH2000102, ucf:45545
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000102
- Title
- NURSING MANAGEMENT AND MIRROR THERAPY FOR PHANTOM LIMB PAIN.
- Creator
-
Henry, Bridget, Allred, Kelly, University of Central Florida
- Abstract / Description
-
Phantom limb pain may occur after the accidental removal or surgical amputation of a limb. Phantom limb pain is the experience of pain in the limb that is no longer present. The clinical management of phantom limb pain is essential in the overall reduction of patient rehabilitation and poor patient outcomes. A patient�s degree of phantom limb pain is influenced by their personal response to loss and pain and can have devastating effects to a person�s social performance, occupational role,...
Show morePhantom limb pain may occur after the accidental removal or surgical amputation of a limb. Phantom limb pain is the experience of pain in the limb that is no longer present. The clinical management of phantom limb pain is essential in the overall reduction of patient rehabilitation and poor patient outcomes. A patient�s degree of phantom limb pain is influenced by their personal response to loss and pain and can have devastating effects to a person�s social performance, occupational role, family role, relationships, and involvement in activities or hobbies. Like most chronic pain, phantom limb pain decreases the quality of life. Not all amputees who suffer from chronic pain respond to traditional therapies. The purpose of this integrated review of the literature was to explore current research and determine the efficacy of mirror therapy in the treatment of Phantom limb pain in amputees. A database search of CINAHL, PubMed (MEDLINE), and OneSearch was conducted. Mirror therapy had no reported side effects, was inexpensive, and was capable of being practiced at home and at the bedside. Relevant findings in the literature revealed a significant decrease in phantom limb pain when using mirror therapy for more than 4 weeks. Although limited research on the use of mirror therapy as an intervention for amputees, existing research supports the efficacy of mirror therapy for the management of phantom limb pain. Nurses and healthcare providers need education on mirror therapy to advocate for their patients to ensure the best possible outcome and reduction of phantom limb pain. Further research on mirror therapy is needed.
Show less - Date Issued
- 2016
- Identifier
- CFH2000028, ucf:45606
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000028
- Title
- USE OF COMPLEMENTARY AND ALTERNATIVE THERAPIES: A PILOT SURVEY.
- Creator
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Ortiz Cintron, Hector, Allred, Kelly, University of Central Florida
- Abstract / Description
-
Meeting patient expectations in relation to pain management is an essential component of palliative and end-of-life care. However, previous research has demonstrated that pain is highly prevalent, especially during the four months prior to death. Poorly controlled pain contributes to cognitive failure, depression and an inability to complete daily activities. Unfortunately, pain and symptom management are often inadequate for patients placed in hospice care. The purpose of this study is to...
Show moreMeeting patient expectations in relation to pain management is an essential component of palliative and end-of-life care. However, previous research has demonstrated that pain is highly prevalent, especially during the four months prior to death. Poorly controlled pain contributes to cognitive failure, depression and an inability to complete daily activities. Unfortunately, pain and symptom management are often inadequate for patients placed in hospice care. The purpose of this study is to evaluate the perspectives of hospice nurses on complementary and alternative therapies to determine if there is an educational need in order to aide in the management of chronic pain in older adults. A survey was developed in order to determine the nursing perceptions of complementary and alternative therapies. A total of 24 participants were recruited. The survey targeted 28 complementary and alternative therapies most commonly used as defined by National Institute for Complementary and Alternative Medicines (NCCAM). Each therapy was ranked on several aspects including perceptions, personal experience, and present knowledge and training. After completing the survey it was found that all participants were either eager or open to use some complementary and alternative therapies in their workplace, in spite of having an educational barrier on how to implement them, and wanted these therapies to become available to patients, families, and staff.
Show less - Date Issued
- 2014
- Identifier
- CFH0004567, ucf:45167
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004567
- Title
- EVALUATION OF COMPUTER-BASED SIMULATION FOR PAIN MANAGEMENT EDUCATION.
- Creator
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Gerardi, Nicole, Allred, Kelly, University of Central Florida
- Abstract / Description
-
Effective pain management is an elusive concept in the acute care setting. Improving nurses' knowledge about optimal pain management is one way to improve the patient's pain experience. A computer-simulation game was developed as an alternative method of teaching the subject of pain management to nursing students. In the game, two patient scenarios are presented, one male and one female. Both patients present with acute pain and request help from the nurse. The player progresses through a...
Show moreEffective pain management is an elusive concept in the acute care setting. Improving nurses' knowledge about optimal pain management is one way to improve the patient's pain experience. A computer-simulation game was developed as an alternative method of teaching the subject of pain management to nursing students. In the game, two patient scenarios are presented, one male and one female. Both patients present with acute pain and request help from the nurse. The player progresses through a series of nine questions as the scenarios unfold, each with one best or correct answer. The purpose of this study was to evaluate the game's potential as a teaching method compared to traditional methods of teaching, such as a lecture. A total of 30 nursing students participated in the study. After playing through the game, each student was asked to complete a post-game survey consisting of 10 standard 5-point Likert scale items and five open-ended questions. The survey was used to evaluate the students' enjoyment of the game, educational benefits, preference compared to traditional teaching methods, and perceived potential to change nursing practice. Results of the survey show that the majority of nursing students enjoyed playing the game and found it captured their attention more than traditional teaching methods. Nine out of the ten Likert scale items received universal high scores. Nursing students were receptive to the computer-simulation game as a teaching method and found it preferable to traditional methods.
Show less - Date Issued
- 2013
- Identifier
- CFH0004347, ucf:44981
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004347
- Title
- THE EFFECTS OF PREOPERATIVE EDUCATION ON STRESS IN THE PEDIATRIC POPULATION.
- Creator
-
Howard, Amy, Allred, Kelly, University of Central Florida
- Abstract / Description
-
The purpose of this research was to critically analyze relevant literature regarding the effects of preoperative education on levels of stress in the pediatric population. The goal of this research is to review and analyze the available literature to determine best practice as it relates to educating the pediatric preoperative patient in order to relieve stress. Research was retrieved from Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and MEDLINE-EBSCOhost databases...
Show moreThe purpose of this research was to critically analyze relevant literature regarding the effects of preoperative education on levels of stress in the pediatric population. The goal of this research is to review and analyze the available literature to determine best practice as it relates to educating the pediatric preoperative patient in order to relieve stress. Research was retrieved from Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and MEDLINE-EBSCOhost databases using keywords pediatric, preoperative, anxiety, stress, fear, children, hospitalized child, education, play therapy, and surgery. Inclusion criteria included research that focused on relieving anxiety or stress in the pediatric surgical patient. Seven research-based articles were found that met the inclusion criteria. Findings indicate surgery is stressful in pediatric patients at all developmental stages. Preoperative education was found to reduce this stress. Verbal, written, and visual means of education all led to a decrease in stress prior to surgery. More research is needed to determine the best developmentally appropriate educational program to relieve stress in the pediatric patient.
Show less - Date Issued
- 2011
- Identifier
- CFH0003809, ucf:44738
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0003809
- Title
- THE IMPACT OF MUSIC ON POSTOPERATIVE PAIN AND ANXIETY.
- Creator
-
Allred, Kelly, Byers, Jacqueline, University of Central Florida
- Abstract / Description
-
Objective: The objective of this study was to add to the body of knowledge about the impact of music on postoperative pain and anxiety. The specific purpose of this research study was to determine if listening to music and/or having a quiet rest period just prior to and just after the first ambulation on postoperative day 1 can reduce pain and/or anxiety, or impact mean arterial pressure, heart rate, respiratory rate, and/or oxygen saturation in patients following a total knee arthroplasty....
Show moreObjective: The objective of this study was to add to the body of knowledge about the impact of music on postoperative pain and anxiety. The specific purpose of this research study was to determine if listening to music and/or having a quiet rest period just prior to and just after the first ambulation on postoperative day 1 can reduce pain and/or anxiety, or impact mean arterial pressure, heart rate, respiratory rate, and/or oxygen saturation in patients following a total knee arthroplasty. Methods: An experimental repeated measures design was used. Setting: A postoperative orthopedic unit in a 300-bed community hospital in the southeastern United States. Sample: Fifty-six patients having a total knee arthroplasty, randomly assigned to either a music intervention group or a quiet rest group. Measures: A visual analog scale was used to measure pain and anxiety. Physiological measures, including blood pressure, heart rate, oxygen saturation, and respiratory rate, were also obtained. Results: A repeated measures analysis of variance between and within groups was conducted for pain and anxiety. Statistical findings between groups indicated the music group's decrease in pain or anxiety was not significantly different from the comparison rest group's decrease in pain (F = 1.120, p = .337) or anxiety (F = 1.566, p = .206) at any measurement point. However, statistical findings within groups indicated that when the groups were combined, the sample had a statistically significant decrease in pain (F = 6.699, p = .001) and anxiety (F = 4.08, p = .013) over time. Post hoc analyses showed the significant decrease in pain was from time 1 (just prior to the initiation of music or rest) to time 2 (just after 20 minutes of music or rest) (t(55) = 4.751, p = .000). Post hoc analyses showed the significant decrease in anxiety was from time 1 (just prior to the initiation of music or rest) to time 2 (just after 20 minutes of music or rest) (t(55) = 2.86, p = .006). Additionally, anxiety decreased significantly from time 3 (just after physical therapy) and time 4 (after second period of 20 minutes of music or rest period) (t(55) = 2.222, p = .030). Implications: Results of this research provides evidence to support the use of music and/or a quiet rest period to decrease pain and anxiety when initiated just before and just after ambulation on postoperative day 1 following a total joint arthroplasty of the knee. The interventions pose no risks, and have the benefits of improved pain reports and decreased anxiety. It potentially could be opioid sparing in some individuals, limiting the negative effects from opioids. Nurses can offer music as an intervention to decrease pain and anxiety in this patient population with confidence, knowing there is evidence to support its efficacy.
Show less - Date Issued
- 2007
- Identifier
- CFE0001634, ucf:47228
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0001634
- Title
- NURSING STUDENTS' ATTITUDE AND COMMITMENT TOWARD SUBSTANCE-ABUSING PATIENTS.
- Creator
-
O'Conner, Amy L, Allred, Kelly, Valenti, Michael, University of Central Florida
- Abstract / Description
-
The topic of substance-abuse has received increasing attention in recent years, as the number of individuals experiencing drug abuse and addiction is on the rise. With substance-use on the rise, the number of patients admitted to the hospital with this disorder is increasing also. It is important hospital staff are aware and educated on how to provide adequate care to these patients without judgement regarding their choices or their lifestyle. This study was done to determine how prepared...
Show moreThe topic of substance-abuse has received increasing attention in recent years, as the number of individuals experiencing drug abuse and addiction is on the rise. With substance-use on the rise, the number of patients admitted to the hospital with this disorder is increasing also. It is important hospital staff are aware and educated on how to provide adequate care to these patients without judgement regarding their choices or their lifestyle. This study was done to determine how prepared nursing students are to care for patients with drug abuse or addiction. Specifically, the project explores student nurses' attitudes and commitment toward substance- abusing patients. The 20 item Drug and Drug Problem Perceptions Questionnaire (DDPPQ) was used to measure attitudes and therapeutic commitment in working with drug-abusing patients, and was distributed electronically to approximately 400 nursing students. One hundred thirty-one students participated. Scores ranged from 22-102, with the smaller value representing greater overall commitment and preparedness when working with substance-abusing patients. The mean score reported overall was 58. This score indicates improvement is needed to increase students' therapeutic commitment and ability to provide quality care for patients experiencing substance- abuse. More research needs to be done and programs put into place to reach this goal.
Show less - Date Issued
- 2018
- Identifier
- CFH2000453, ucf:45709
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000453
- Title
- The Effectiveness of Virtual Humans vs Pre-Recorded Humans in a Standardized Patient Performance Assessment.
- Creator
-
Palathinkal, Joel, Kincaid, John, Shumaker, Randall, Allred, Kelly, Smith, Roger, University of Central Florida
- Abstract / Description
-
A Standardized Patient (SP) is a trained actor who portrays a particular illness to provide training to medical students and professionals. SPs primarily use written scripts and additional paper-based training for preparation of practical and board exams. Many institutions use various methods for training such as hiring preceptors for reenactment of scenarios, viewing archived videos, and computer based training. Currently, the training that is available can be enhanced to improve the level...
Show moreA Standardized Patient (SP) is a trained actor who portrays a particular illness to provide training to medical students and professionals. SPs primarily use written scripts and additional paper-based training for preparation of practical and board exams. Many institutions use various methods for training such as hiring preceptors for reenactment of scenarios, viewing archived videos, and computer based training. Currently, the training that is available can be enhanced to improve the level of quality of standardized patients. The following research is examining current processes in standardized patient training and investigating new methods for clinical skills education in SPs. The modality that is selected for training can possibly affect the performance of the actual SP case.This paper explains the results of a study that investigates if there is a difference in the results of an SP performance assessment. This difference can be seen when comparing a virtual human modality to that of a pre-recorded human modality for standardized patient training. The sample population navigates through an interactive computer based training module which provides informational content on what the roles of an SP are, training objectives, a practice session, and an interactive performance assessment with a simulated Virtual Human medical student. Half of the subjects interact with an animated virtual human medical student while the other half interacts with a pre-recorded human. The interactions from this assessment are audio-recorded, transcribed, and then graded to see how the two modalities compare. If the performance when using virtual humans for standardized patients is equal to or superior to pre-recorded humans, this can be utilized as a part task trainer that brings standardized patients to a higher level of effectiveness and standardization. In addition, if executed properly, this tool could potentially be used as a part task trainer which could provide savings in training time, resources, budget, and staff to military and civilian healthcare facilities.
Show less - Date Issued
- 2011
- Identifier
- CFE0004149, ucf:49037
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0004149
- Title
- Predictors of Immunosuppressant Adherence in Long-Term Renal Transplant Recipients.
- Creator
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Galura, Sandra, Sole, Mary, Allred, Kelly, Byers, Jacqueline, Lawrence, Shawn, University of Central Florida
- Abstract / Description
-
To sustain the health and viability of renal transplants, adherence to immunosuppressant therapy (IST) medications is critical. Studies continue to identify decreased adherence rates as time from transplant increases (Chisholm-Burns, Kwong, Mulloy (&) Spivey, 2008; Chisholm, Lance, Mulloy, 2005; Chisholm, Mulloy, (&) DiPiro, 2005; Nivens (&) Thomas, 2009). While previous research has explored the effect of variables known to influence IST adherence in adult renal transplant recipients,...
Show moreTo sustain the health and viability of renal transplants, adherence to immunosuppressant therapy (IST) medications is critical. Studies continue to identify decreased adherence rates as time from transplant increases (Chisholm-Burns, Kwong, Mulloy (&) Spivey, 2008; Chisholm, Lance, Mulloy, 2005; Chisholm, Mulloy, (&) DiPiro, 2005; Nivens (&) Thomas, 2009). While previous research has explored the effect of variables known to influence IST adherence in adult renal transplant recipients, limited studies have explored these variables in a population of renal transplant recipients with longer time posttransplant intervals. The purpose of this study was to examine demographic variables, time posttransplant, immunosuppressive agents, health beliefs, social support, and symptom experience and test their relationship to adherence in a population of long-term renal transplant recipients.A cross-sectional correlational design was used to collect data from a convenience sample of 98 adult renal transplant recipients who were three or more years from transplant. Participants completed five instruments: 1) demographic survey, 2) the Beliefs About Medicines Questionnaire (BMQ), 3) the Medical Outcomes Study (MOS) Modified Social Support Survey (&)#172;(&)#172;(&)#172;(&)#172;(&)#172;(&)#172;(&)#172;(&)#172;(&)#172;(&)#172;(&)#172;(&)#172;(&)#172;(&)#172;(&)#172; (MSSS), 4) the Basel Assessment of Adherence with Immunosuppressive Medication Scales (BAASIS), and 5) the Modified Transplant Symptom Occurrence and Symptom Distress Scale-59R (MTSOSD-59R). A composite adherence score (CAS) consisting of a self-report measure of adherence (BAASIS), nontherapeutic serum drug assay, and collateral report of adherence as provided by two transplant clinic professionals was used to determine final adherence group classification (adherent/nonadherent). Analysis of the relationship between all independent variables and adherence was conducted using Spearman's rho correlation coefficient. Mean scores for medication complexity, health beliefs, social support, and symptom experience were compared between age, gender, and time posttransplant groups using independent-samples t tests. A logistic regression prediction of probability was conducted to determine which of the variables that demonstrated a significant relationship to adherence were most predictive of adherence.Of the total sample population (N = 98), 39.8% (n = 39) were classified as adherent and 60.2% (n = 59) were nonadherent. Results demonstrated no significant relationship between age (continuous variable), time posttransplant, immunosuppressant medications (measured by a medication complexity index), health beliefs, symptom experience, and adherence. Weak, but significant relationships between age groups (r = -.213, p=.035), tangible social support (r = .215, p =.017), emotional informational social support (r = .274, p = .003), positive social interaction support (r = .199, p = .025), total overall social support (r = .274, p =.003) and composite adherence group classification were found. Older participants ((>) 55 yrs) were significantly less adherent than younger ((<) 54 yrs) participants. Mean scores for emotional / informational (EMI), positive social interaction (POS), and total social support (MSSS) were significantly lower in nonadherent participants. Regression results indicated the overall model of two predictors (age grouped [(<) 54 yrs; (>) 55 yrs] and EMI social support subscale) was statistically reliable in distinguishing between adherent and nonadherent participants (-2 Log Likelihood 116.244; Goodness-of-Fit x2 (2) = 13.664, p = .001), correctly classifying 69.1% of the cases. Findings from this study contribute to the body of research exploring predictors of immunosuppressant adherence in long-term renal transplant recipients. Data suggest both younger age ((<) 55) and categories of social support predict adherence in long-term renal transplant recipients. Healthcare providers caring for renal transplant recipients long-term should consider annually assessing older participants for adherence as well as for changes in social networks.
Show less - Date Issued
- 2012
- Identifier
- CFE0004203, ucf:49013
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0004203
- Title
- Bleeding Control Using Multiple Amputee Trauma Trainer in Medical Simulation: Comparison of Movement Versus Non-Movement in Training.
- Creator
-
Allen, Christine, Kincaid, John, Schatz, Sarah, Allred, Kelly, Talbert, Steven, Sotomayor, Teresita, University of Central Florida
- Abstract / Description
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Army first responders, specifically Combat Medics and Combat Lifesavers, provide medical intervention while in the field. Didactic as well as hands-on training helps to prepare these first responders, and one module they receive involves bleeding control. First responders are taught to use the Combat Application Tourniquet(&)#174; (CAT(&)#174;) to stop bleeding from limbs subjected to severe injury such as amputation, gunshot, or severe lacerations. A training aid like the Multiple Amputee...
Show moreArmy first responders, specifically Combat Medics and Combat Lifesavers, provide medical intervention while in the field. Didactic as well as hands-on training helps to prepare these first responders, and one module they receive involves bleeding control. First responders are taught to use the Combat Application Tourniquet(&)#174; (CAT(&)#174;) to stop bleeding from limbs subjected to severe injury such as amputation, gunshot, or severe lacerations. A training aid like the Multiple Amputee Trauma Trainer(TM) (MATT(TM)) simulator provides tourniquet training using a lifelike bilateral lower limb amputee. In addition, MATT(TM) combines movement and resistance while the first responder applies the tourniquet, mimicking conditions one would see in a real situation. This research describes tourniquet history, appropriate usage, field tourniquet review, surgical tourniquet, CAT(&)#174; bleeding intervention procedures, bleeding physiology and complications, prehospital tourniquet use in recent conflicts, medical simulation fidelity, and a review of the value of animatronic movement during tourniquet simulation-based training. I then evaluate the effectiveness of animatronic movement during tourniquet training using the Advanced MATT in an experiment using Army first responders. The control group experienced no movement while the experimental group experienced movement when applying a tourniquet during the lab-training. Each group then alternately experienced Advanced MATT movement during an immersive scenario along with fog, strobe lights, and battle sounds. It was hypothesized that 1) In the immersive scenario, the experimental groups (i.e., those who were trained on a moving simulator) would have a faster reaction time as compared to those participants who did not receive training on the moving Advanced MATT simulator; 2) In the lab-based training, the experimental groups would have a slower reaction time; 3) In the immersive scenario, the experimental groups would have a faster tourniquet application time when subjected to movement while in the lab-based training, but the experimental groups would also have a slower tourniquet application time when initially subjected to movement in the laboratory-based training; finally, 4, 5, and 6) Participants who completed lab-based tourniquet training on the Advanced MATT simulation with animatronic movement would report higher perceived realism scores than participants who complete the training on a static version of the Advanced MATT and participants who completed a tourniquet training immersive scenario on the Advanced MATT simulation with movement would report higher perceived realism, presence, and self-efficacy scores than participants who complete the training on a static version of the Advanced MATT. The empirical results show a significant overall training effect of the Advanced MATT simulator (with or without movement). For reaction time and tourniquet application time, involving simulator movement was significant over varying scenarios. A small reduction in reaction and tourniquet application time on the battlefield may be extremely beneficial on the battlefield. Participants who received movement generally gave more positive reactions than those who did not received movement, although these results failed to reach statistical significance. Participants who received movement, followed by a scenario without movement rated the subjective ratings the lowest, suggestive of the lack of movement. Furthermore, despite the order movement was received, no large drops in performance occurred in any condition, indicating that negative training was avoided.
Show less - Date Issued
- 2011
- Identifier
- CFE0004468, ucf:49316
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0004468
- Title
- Nursing Students and Tuckman's Theory: Building Community Using Cohort Development.
- Creator
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Austin, George, Cintron Delgado, Rosa, Owens, James, Boyd, Tammy, Cox, Thomas, Allred, Kelly, University of Central Florida
- Abstract / Description
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This study explored the phenomenon of first year students who lived in a nursing living learning community and their experiences during their first year. The researcher utilized a qualitative research methodology to investigate the social and academic aspects that influenced these students as they worked to prepare to apply to the nursing program on their way to becoming nurses. Of the 68 students who lived in the community in the first two years, 12 were interviewed in a face-to-face setting...
Show moreThis study explored the phenomenon of first year students who lived in a nursing living learning community and their experiences during their first year. The researcher utilized a qualitative research methodology to investigate the social and academic aspects that influenced these students as they worked to prepare to apply to the nursing program on their way to becoming nurses. Of the 68 students who lived in the community in the first two years, 12 were interviewed in a face-to-face setting. The researcher used Tuckman's Stages of Group Development as the framework for this study, recognizing that groups go through several stages depending on the length of time that the group is together. The participants' experiences were examined on a group and individual level, in order to fully understand their experiences in the community, including their persistence through applying to and enrolling in the nursing program. This study brought voice to the experiences of the students, helping to understand why they came together, how the community developed, and what lessons the students took away from living in this community. It was made clear during the interviews that the students chose to live in the community where they would be surrounded by students with the same goals. They also felt very strongly about academics taking a priority over social events, and believed that the community should have a second semester common course to keep the students working together throughout the duration of the first year.
Show less - Date Issued
- 2013
- Identifier
- CFE0004972, ucf:49576
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0004972
