Changes in treatment outcomes in patients undergoing an integrated psychosomatic inpatient treatment: Results from a cohort study.

Objective: In Germany, multimodal psychosomatic inpatient treatment can be initiated for patients with substantial mental disorders (e.g., depression, anxiety, somatoform disorders) and comorbid physical disease.

The Distraction in Action Tool©: Feasibility and Usability in Clinical Settings.

Purpose: Distraction is a relatively simple, evidence-based intervention to minimize child distress during medical procedures. Timely on-site interventions that instruct parents on distraction coaching are needed. The purpose of this study was to test the feasibility and usability of the Distraction in Action Tool© (DAT©), which 1) predicts child risk for distress with a needle stick and 2) provides individualized instructions for parents on how to be a distraction coach for their child in clinical settings.

Iowa Model of Evidence-Based Practice: Revisions and Validation.

Background: The Iowa Model is a widely used framework for the implementation of evidence-based practice (EBP). Changes in health care (e.g.

Radiation from wireless technology elevates blood glucose and body temperature in 40-year-old type 1 diabetic male.

A type 1 diabetic male reports multiple instances when his blood glucose was dramatically elevated by the presence of microwave radiation from wireless technology and plummeted when the radiation exposure ended. In one instance, his body temperature elevated in addition to his blood glucose. Both remained elevated for nearly 48 h after exposure with the effect gradually decreasing.

Relationship of Genetic Variants With Procedural Pain, Anxiety, and Distress in Children.

Objective: This study used a candidate gene approach to examine genomic variation associated with pain, anxiety, and distress in children undergoing a medical procedure.

Study Design: Children aged 4-10 years having an IV catheter insertion were recruited from three Midwestern children's hospitals. Self-report measures of pain, anxiety, and distress were obtained as well as an observed measure of distress.

Relaxation Training and Postoperative Music Therapy for Adolescents Undergoing Spinal Fusion Surgery.

Spinal fusion for idiopathic scoliosis is one of the most painful surgeries experienced by adolescents. Music therapy, utilizing music-assisted relaxation with controlled breathing and imagery, is a promising intervention for reducing pain and anxiety for these patients. It can be challenging to teach new coping strategies to post-operative patients who are already in pain.

Interface pressure redistribution on skin during continuous lateral rotation therapy: A feasibility study.

Background: Continuous Lateral Rotation Therapy (CLRT) is a therapy used in ICUs for early mobilization of ventilated patients. CLRT is believed by some in health care to not be sufficient to allow for capillary re-perfusion, and may lead to tissue damage.

Objectives: To determine if there are differences in skin interface pressures, skin integrity, or perceived discomfort across three positioning scenarios.

Matching doses of distraction with child risk for distress during a medical procedure: a randomized clinical trial.

Background: Parents often want to provide support to their children during medical procedures, but not all parents are effective in providing distraction after brief training.

Objective: The aim of this study was to investigate the effects of three doses of distraction intervention for children at high and medium risk for procedure-related distress.

Methods: Children undergoing scheduled intravenous insertions for diagnostic or treatment purposes and their parents participated.

[Stability of mental stress-induced hemodynamic and autonomic reaction despite successful treatment for psychosomatic disorder].

Autonomic imbalance and exaggerated stress responses are associated with an increased risk of morbidity and mortality and have been associated with several psychosomatic disorders. Has in-patient psychotherapy any effect on autonomic regulation and mental stress reactivity? In 77 patients undergoing in-patient psychometric treatment psychometric examination and psychophysiological assessment of hemodynamic and autonomic parameters during rest and 2 mental stress tests was performed at the beginning and at the end of in-patient psychotherapy. Despite marked improvements in symptoms our short-term treatment for psychosomatic disorders did not affect autonomic and hemodynamic activation at rest or during stress testing.

Validation of a clinically useful measure of children's state anxiety before medical procedures.

Purpose: Assessment of children's anxiety in busy clinic settings is an important step in developing tailored interventions. This article describes the construct validation of the Children's Anxiety Meter-State (CAM-S), a brief measure of state anxiety.

Design And Methods: Existing data were used to investigate the associations between child self-reports of anxiety, parent reports of child anxiety, and observed child distress during an intravenous procedure.

An exploration of context and the use of evidence-based nonpharmacological practices in emergency departments.

Background: The uptake of evidence in practice remains a challenge for healthcare professionals including nurses and providers. Increased use of evidence-based practices (EBPs) in healthcare settings may improve patient conditions such as pain and decrease the cost of health care. The relationship between context in the practice environment and uptake of EBP remains an understudied area.

Adolescents' perceptions of music therapy following spinal fusion surgery.

Aims And Objectives: To explore adolescents' memories about music therapy after spinal fusion surgery and their recommendations for future patients.

Background: Spinal fusion for adolescent idiopathic scoliosis is one of the most painful surgeries performed. Music therapy is shown to decrease postoperative pain in children after minor surgery.

Building a computer program to support children, parents, and distraction during healthcare procedures.

This secondary data analysis used data mining methods to develop predictive models of child risk for distress during a healthcare procedure. Data used came from a study that predicted factors associated with children's responses to an intravenous catheter insertion while parents provided distraction coaching. From the 255 items used in the primary study, 44 predictive items were identified through automatic feature selection and used to build support vector machine regression models.

[Psychological distress of breast cancer patients: screening and patients' request for psycho-oncological care as indicators of health-related quality of life].

Health-related quality of life (QoL) in breast cancer patients strongly depends on emotional well-being. QoL (EORTC-QLQ-C30), psychological distress (HADS), and patient's request for psycho-oncological care were assessed in 103 breast cancer patients during initial hospitalization. Clinical diagnoses according to ICD-10-F were made by clinical interview.

Evidence-based pediatric pain management in emergency departments of a rural state.

Unlabelled: Evidence-based pediatric pain management (EBPPM) has been identified as a practice too often overlooked in Emergency Departments (EDs). Studies show EBPPM is practiced inconsistently in urban EDs, and even less is known about the practice in rural EDs. The objectives of this study were: A) Determine the frequencies with which specific EBPPM practices are used in EDs of a primarily rural state; and B) Explore the differences in EBPPM practice in Critical Access, rural, and urban hospital EDs.

Salivary cortisol responsivity to an intravenous catheter insertion in children with attention-deficit/hyperactivity disorder.

Objective: To compare salivary cortisol baseline levels and responsivity as well as behavioral distress to intravenous (IV) catheter insertions in 4- to 10-year-old children with (n = 29) and without (n = 339) attention-deficit/hyperactivity disorder (ADHD).

Methods: This is a secondary data analysis from a sample of 542 children who participated in a multisite study on distraction. Data included were demographic variables, Pediatric Behavior Scale-30, Observational Scale of Behavioral Distress-Revised, and four salivary cortisol samples.

Factors explaining children's responses to intravenous needle insertions.

Background: Previous research shows that numerous child, parent, and procedural variables affect children's distress responses to procedures. Cognitive-behavioral interventions such as distraction are effective in reducing pain and distress for many children undergoing these procedures.

Objectives: The purpose of this report was to examine child, parent, and procedural variables that explain child distress during a scheduled intravenous insertion when parents are distraction coaches for their children.

Impact of Parent-Provided Distraction on Child Responses to an IV Insertion.

This study evaluates the impact of parent-provided distraction on children's responses (behavioral, physiological, parent, and self-report) during an IV insertion. Participants were 542 children, 4 to 10 years old, randomized to an experimental group that received a parent distraction coaching intervention or to routine care. Experimental group children had significantly less cortisol responsivity (p = .

Normative salivary cortisol values and responsivity in children.

This was a descriptive study on normative salivary cortisol values and responsivity to a hospital clinic visit and an intravenous (IV) procedure in children. The study presented was a subproject of a primary research study that examined parents coaching their children requiring an IV placement in the use of distraction. One measure of child response in the primary study, salivary cortisol, was included to further our understanding of children's physiologic response to stressful and painful stimuli.

Pain-sensitive temperament and postoperative pain.

Purpose: To describe the relationship between pain-sensitive temperament and self-report of pain intensity following surgery.

Design And Methods: Fifty-nine adolescents and young adults (average age 14 years) undergoing spinal fusion for adolescent idiopathic scoliosis completed the Sensitivity Temperament Inventory for Pain-Child version (STIP-C). The Pearson correlation between STIP-C scores and the highest pain intensity for each of the first three postoperative days was investigated.

Striving for distraction. Interview by James M Stubenrauch.

As part of its Raise the Voice campaign, in November 2006 the American Academy of Nursing (AAN) named Ann marie McCarthy and Charmaine Kleiber as "Edge Runners"--nurses who identify new models of care that integrate the physical and mental health of patients and who make a "clear connection between research and practical solutions." Pat Fort-Rogner, chief executive officer of the AAN, says "We hope patient-advocacy groups and federal agencies like the Agency for Healthcare Research and Quality will take note."

Predictors of topical anesthetic effectiveness in children.

Unlabelled: Some children report significant pain with peripheral intravenous catheter (IV) insertion, despite the appropriate use of topical lidocaine anesthetics. This analysis of data from an existing study identified factors related to variation in topical anesthetic effectiveness used for IV insertion. The children (n = 218) in this investigation were 4 to 10 years old and undergoing a scheduled IV insertion.

Integrating molecular genetics analyses into clinical research.

The integration of molecular genetics approaches into the study of complex health phenomena is an increasingly important and available strategy for researchers across the health science disciplines. Pain sensation and response to painful stimuli are examples of complex health phenomena that are particularly amenable to molecular genetics approaches. Both human and animal model research suggests that differences in these responses may be related, in part, to variation in the genes that modulate sensation and behavior.