Can educational methods influence the popularity of psychiatric nursing?

The ongoing difficulty of attracting sufficient numbers of undergraduate nursing students to a career in psychiatric nursing has been acknowledged. Limited available research suggests that education can produce a more positive view of psychiatric nursing. Despite these findings, research into the impact of educational methods upon the popularity of psychiatric nursing has not been undertaken. This paper reports the findings of a quasi-experimental research project, which examined the relationship between the study of, and the popularity of, psychiatric nursing. The results propose that through undertaking the psychiatric nursing program, psychiatric nursing as a future career option became more popular. The greater significance of the results of this study than had been found in previous studies suggests that problem-based learning is an educational method capable of influencing the development of more positive attitudes.     

What is the influence of severity levels of knee osteoarthritis on gait initiation?

BackgroundThe anticipatory postural adjustments required for gait initiation have not yet been investigated in older adults with different levels of severity of knee osteoarthritis. This study aimed to evaluate the anticipatory postural adjustments adopted by older adults with different severity levels of knee osteoarthritis during gait initiation.MethodsSixty-seven older adults with knee osteoarthritis (mild, moderate, and severe levels) and 11 healthy older adults control were evaluated bilaterally with a force plate to analyze gait initiation. The center of pressure trajectory during gait initiation was divided into four phases: three anticipatory postural adjustments, and a locomotor phase. The length, duration, and velocity of each phase were calculated.FindingsThe results showed that during the right and left limbs swing forward, the severe and moderate knee osteoarthritis groups presented a significant reduction in the length of anticipatory postural adjustment phases, locomotion, duration, and velocity (P < 0.05). The severe knee osteoarthritis group presented a significantly higher body mass index (P < 0.003) than the other groups. However, just the healthy group presented a correlation between body mass index and anticipatory postural adjustments.InterpretationOur results demonstrated that older adults with severe and moderate levels of knee osteoarthritis adopt longer lasting and slower anticipatory postural adjustment phases, lower locomotion, and lower center of pressure displacement during gait initiation, suggesting that this population has adaptive strategy in performing gait initiation, which is significantly changed by the knee osteoarthritis severity level.     

Do suicidal ideation and behaviour influence duration of psychiatric hospitalization?

Suicidal ideation and behaviour are sometimes considered to be manipulative, with the intention of escaping from intolerable situations leading to prolonged hospitalization. The present study examined the length of hospitalization of those who had attempted suicide or had suicidal ideation compared to non-suicidal patients, as measured by the Health of the Nation Outcome Scales in two private psychiatric hospitals. Suicidal patients had a significantly shorter length of hospitalization, despite their significantly greater degree of psychiatric morbidity. Results indicated that it is erroneous to preclude inpatient care for those who are suicidal on the assumption that it will promote prolonged hospitalization.     

Can the type of catheter and the use of irradiated red blood cells for transfusion in neonates influence the occurrence of hemolysis?

AimTo compare hemolysis marker levels of irradiated and non-irradiated packed red blood cells (PRBCs) after infusion by different neonates intravenous catheter.MethodExperimental study. Irradiated and non-irradiated PRBCs administered in vitro in peripheral intravenous catheter (PIVC),Umbilical (UC), and peripheral intravenous central catheter (PICC). Collected aliquots directly from PRBC bag, after filling the infusion system and catheter infusion. The hemolytic markers analyzed were: degree of hemolysis; hematocrit–Hct; total hemoglobin–THb; free hemoglobin–FHb; potassium– K; and lactate dehydrogenase–LDH.ResultsPVIC did not significantly influence hemolysis marker levels. The UC infusion influenced levels of FHb (p = 0.005), K (p = 0.001) and THb (p = 0.001); while PICC demonstrated significant effect on FHb (p = 0.010), degree of hemolysis (p = 0.026) and LDH (p = 0.050) levels in non-irradiated and irradiated PRBCs.ConclusionIn vitro infusion of irradiated and non-irradiated PRBCs resulted in significant changes in the levels of UC and PICC hemolysis markers, however, such levels do not contraindicate their use in neonatal transfusion.     

Is latero-medial patellar mobility related to the range of motion of the knee joint after total knee arthroplasty?

Diminished range of motion (ROM) of the knee joint after total knee arthroplasty (TKA) is thought to be related to reduced patellar mobility. This has not been confirmed clinically due to a lack of quantitative methods adequate for measuring patellar mobility. We investigated the relationship between patellar mobility by a reported quantitative method and knee joint ROM after TKA. Forty-nine patients [osteoarthritis – OA: 29 knees; rheumatoid arthritis – RA: 20 knees] were examined after TKA. Respective medial and lateral patellar mobility was measured 1 and 6 months postoperatively using a patellofemoral arthrometer (PFA). Knee joint ROM was also measured in each of those 2 sessions. Although the flexion and extension of the knee joints improved significantly from 1 to 6 months after TKA, the medial and lateral patellar displacements (LPDs) failed to improve during that same period. Moreover, only the changes in knee flexion and medial patellar displacement (MPD) between the two sessions were positively correlated (r = 0.31, p < 0.05). However, our findings demonstrated that medial and lateral patellar mobility had no sufficient longitudinal relationship with knee ROM after TKA.     

Can the Internet be used as a medium to evaluate knee angle?

Telemedicine promises to revolutionize medical care delivery in rural and remote areas. The ability to accurately evaluate physical impairment via the Internet is important to the possible future provision of Internet-based physiotherapy. This study evaluated the reliability and validity of assessing knee range of motion via the Internet. Two therapists evaluated knee angle on a single subject via two methods of assessment: the Internet and the traditional method (face-to-face). Nine random positions of the knee were chosen with the principal examiner performing 20 face-to-face and two sets of 20 Internet measures in each position (n=540). The secondary therapist performed Internet assessments only. The Internet connection was established at a readily available speed of 17 kbit/s. The Internet-based goniometer was found to be a valid tool for measuring both knee flexion and extension angles. It was shown to possess both high intra and inter-rater reliability. Difference average plots of the scores verified the consistency of measurement between both modes of assessment. The successful evaluation of the physical outcome measure of knee range of motion via the Internet assists the further development of Internet-based physiotherapy applications.     

Are you in control of the method or is the method in control of you?

The starting point for this article is the concept that there is a risk in slavishly adhering to one particular method in nursing education. With this approach in mind, the aim was to examine the use of an educational model with drama in relation to Gadamer's idea of method, as well as to discuss the conditions for lifeworld dialogues in learning encounters.     

Do patients with diabetes wear shoes of the correct size?

BACKGROUND: Fifteen per cent of patients with diabetes will develop a foot ulcer at some point in their life. Ill-fitting footwear frequently contributes to foot ulceration. A good fitting shoe is an essential component in the management of the diabetic foot. The objective of this study was to assess the feet and footwear of patients with diabetes to determine whether they are wearing the correct-sized shoes. METHODS: One-hundred patients with diabetes who were attending the general diabetic clinic had their foot length measured using a 'Clarks' shoe shop device and foot width using a pair of callipers. Measurements were taken whilst seated and standing. Shoe dimensions were also assessed by recording the manufactured shoe length and using callipers to assess shoe width. A calibrated measuring stick standardised shoe lengths. Neurovascular status and the presence of deformities in the foot were also recorded. RESULTS: One-third of diabetic patients were wearing the correct shoes on either foot whilst seated or whilst standing. However, only 24% of patients were wearing shoes that were of the correct length and width for both feet whilst seated and 20% upon standing. Seventeen per cent of patients appeared in both groups. No significance was found between any other variables, such as sensory neuropathy. CONCLUSIONS: Many patients with diabetes wear shoes that do not fit, particularly, shoes that are too narrow for their foot width. Assessing the appropriateness of footwear maybe an important part of foot examination.     

Stability of the distal phalanx fracture — A biomechanical study on the importance of the nail and the influence of fixation by crossing Kirschner wires

BackgroundWith respect to the stability of displaced distal-phalanx fracture, the relevance of nail loss and the biomechanical effects of fixation using crossed Kirschner wires have not been investigated. The present study aimed to determine whether the nail or the type of fixation contributes to stabilizing distal-phalanx fracture.MethodsIn 48 specimens (fingers), a model of the comminuted fracture of the distal phalanx (AO type A3) was created by resecting a 1-mm osseous segment from the distal phalanx. Specimens were assigned to one of four groups, depending on whether the fracture was accompanied with nail loss, and whether the fracture fixation employed a single Kirschner wire or a crossing of two Kirschner wires. Each specimen was subjected to either a bending or a torsion test.FindingsRegardless of the fixation form, the mean peak bending and torsion forces were higher for the specimens with the nail intact. Furthermore, these forces were also higher in specimens which had received fixations based on the Kirschner wires, compared to those specimens which had received fixations based on a single Kirschner wire. The highest mean peak torque 1.39 (0.12) N·m was found for the specimens with no nail loss and fixation using two crossed Kirschner wires, while the lowest mean peak torsion 0.46 (0.02) N·m was found for specimens with nail loss and fixation using a single Kirschner wire.InterpretationOur results suggest that the nail can provide additional stability for comminuted fractures of the distal phalanx after fixation. Furthermore, when nail loss occurs, fixation using two crossed Kirschner wires can provide significantly more stability than fixation using single Kirschner wire.     

Can acupuncture ease the symptoms of menopause?

In a randomized, 2-group clinical study, acupuncture was used for the relief of menopausal hot flushes, sleep disturbances, and mood changes. The experimental acupuncture treatment consisted of specific acupuncture body points related to menopausal symptoms. The comparison acupuncture treatment consisted of a treatment designated as a general tonic specifically designed to benefit the flow of Ch'i (energy). Results from the experimental acupuncture treatment group showed a decrease in mean monthly hot flush severity for site-specific acupuncture. The comparison acupuncture treatment group had no significant change in severity from baseline over the treatment phase. Sleep disturbances in the experimental acupuncture treatment group declined over the study. Mood changes in both the experimental acupuncture treatment group and the comparison acupuncture treatment group showed a significant difference between the baseline and the third month of the study. Acupuncture using menopausal-specific sites holds promise for nonhormonal relief of hot flushes and sleep disturbances.     

Can a clinical placement influence stigma? An analysis of measures of social distance

BackgroundThe way people who experience mental illness are perceived by health care professionals, which often includes stigmatising attitudes, can have a significant impact on treatment outcomes and on their quality of life.ObjectiveTo determine whether stigma towards people with mental illness varied for undergraduate nursing students who attended a non-traditional clinical placement called Recovery Camp compared to students who attended a ‘typical’ mental health clinical placement.DesignQuasi-experimental.ParticipantsSeventy-nine third-year nursing students were surveyed; n = 40 attended Recovery Camp (intervention), n = 39 (comparison group) attended a ‘typical’ mental health clinical placement.MethodsAll students completed the Social Distance Scale (SDS) pre- and post-placement and at three-month follow-up. Data analysis consisted of a one-way repeated measures analysis of variance (ANOVA) exploring parameter estimates between group scores across three time points. Two secondary repeated measures ANOVAs were performed to demonstrate the differences in SDS scores for each group across time. Pairwise comparisons demonstrated the differences between time intervals.ResultsA statistically significant difference in ratings of stigma between the intervention group and the comparison group existed. Parameter estimates revealed that stigma ratings for the intervention group were significantly reduced post-placement and remained consistently low at three-month follow-up. There was no significant difference in ratings of stigma for the comparison group over time.ConclusionsStudents who attended Recovery Camp reported significant decreases in stigma towards people with a mental illness over time, compared to the typical placement group. Findings suggest that a therapeutic recreation based clinical placement was more successful in reducing stigma regarding mental illness in undergraduate nursing students compared to those who attended typical mental health clinical placements.     

Can muscle weakness and disability influence the relationship between pain catastrophizing and pain worsening in patients with knee osteoarthritis? A cross-sectional study

ObjectiveTo verify if the relationship between pain catastrophizing and pain worsening would be mediated by muscle weakness and disability in patients with symptomatic knee osteoarthritis.MethodsThis was a cross-sectional study in a hospital out-patient setting. Convenience sampling was used with a total of 50 participants with symptomatic knee osteoarthritis. Pain and the activities of daily livings (ADL) were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale. Pain catastrophizing was assessed using the Coping Strategy Questionnaire (CSQ) subscale. Muscle strength of knee extension and 30-s chair stand test (30CST) were also assessed. Path analysis was performed to test the hypothetical model. Goodness of fit of models were assessed by using statistical parameters such as the chi-square value, goodness of fit index (GFI), adjusted goodness of fit index (AGFI), comparative fit index (CFI), and root mean square error of approximation (RMSEA).ResultsThe chi-square values were not significant (chi-square = 0.283, p = 0.594), and the indices of goodness of fit were high, implying a valid model (GFI = 1.000; AGFI = 0.997; CFI = 1.000; RMSEA = 0.000). Pain was influenced significantly by muscle strength and ADL; muscle strength was influenced significantly by ADL via 30CST; ADL was influenced by pain catastrophizing.ConclusionThe relationship between pain catastrophizing with pain worsening are mediated by muscle weakness and disability.