Nursing research
-
The incidence rate of breast cancer is rising rapidly in Hong Kong. Lymphedema is a serious long-term complication of breast cancer surgery and radiation therapy. ⋯ Previous inflammation-infection and advanced age at axillary dissection are risk factors associated with the initiation of lymphedema. Previous inflammation-infection, operation on the side of the dominant hand, obesity, and aging are potential risk factors associated with the aggravation of lymphedema. Greater BMI is still a risk factor for lymphedema progression even in a lower BMI population.
-
Research evidence suggests that nurse staffing influences patient outcomes. ⋯ Nurse and physician staffing and specialization of ICUs impacted patient mortality. Associations differed in tertiary and secondary hospitals. Further investigation of the impact of organizational environments in ICUs is needed.
-
Time pressure and, occasionally, suboptimal assessment decisions are features of nursing in acute care. ⋯ Time pressure reduced nurses' ability to detect the need and the tendency to report intervening. Thus, there were more failures to report appropriate intervention under time pressure, and the positive effects of clinical experience were negated under time pressure. More and larger scale research on the effect on clinical outcomes of time pressured nursing choices is required.
-
Statistical mediation is an important tool in behavioral health sciences, but it has been confined primarily to continuous variables. As prevention studies become increasingly common, more often the mediator or outcome is binary. Recent work by D. P. MacKinnon and J. H. Dwyer (1993) has explicated the steps necessary to estimate models for mediation when the mediator or the outcome is binary. ⋯ The SAS macros are available for download without charge from the second author's Web site. Instructions are provided in an included technical manual.
-
Clinical Trial
Improving patient-clinician communication about chronic conditions: description of an internet-based nurse E-coach intervention.
Studies show that patients who have higher self-efficacy and participate actively in their care have better disease management. Patient-provider Internet portals offer an exciting new venue for empowering and engaging patients in better management of chronic conditions. ⋯ The Internet-based coaching intervention departs substantially from usual nursing care but warrants further study given its potential to offer considerable benefits to large numbers of patients. Several challenges were identified to providing patient coaching and self-management support via the Internet, but this efficient and low-cost approach offers an innovative opportunity to improve patient-clinician partnerships in managing chronic conditions. As patients become more accustomed to electronic communication, nurses can play an important role, joining efforts to develop this new realm to promote patients as partners in managing their health conditions.