Preventing pressure ulcers in hospitals: A systematic review of nurse-focused quality improvement interventions.

Background: A systematic review of the literature on nurse-focused interventions conducted in the hospital setting informs the evidence base for implementation of pressure ulcer (PU) prevention programs. Despite the availability of published guidelines, there is little evidence about which interventions can be successfully integrated into routine care through quality improvement (QI). The two previous literature syntheses on PU prevention have included articles from multiple settings but have not focused specifically on QI.

Depression and medication adherence in the treatment of chronic diseases in the United States: a meta-analysis.

Objective: To conduct a meta-analysis of the association between depression and medication adherence among patients with chronic diseases. Poor medication adherence may result in worse outcomes and higher costs than if patients fully adhere to their medication regimens.

Data Sources: We searched the PubMed and PsycINFO databases, conducted forward searches for articles that cited major review articles, and examined the reference lists of relevant articles.

Increased substance use and risky sexual behavior among migratory homeless youth: exploring the role of social network composition.

Travelers are a migratory subgroup of homeless youth who may be especially prone to engaging in risky behavior. This study compared the substance use and sexual behavior of young homeless travelers and non-travelers to evaluate the extent and possible sources of travelers' increased risk. Data came from face-to-face interviews with 419 homeless youth (36.

Predictors of unrecognized HIV infection among poor and ethnic men who have sex with men in Los Angeles.

This study evaluates associations between unrecognized HIV infection and demographic factors, internalized homonegativity, drug use, and sexual behaviors among HIV positive men who have sex with men (MSM). We analyzed data from 347 HIV positive participants from the Los Angeles site for NIDA's Sexual Acquisition and Transmission of HIV-Cooperative Agreement Program. Participants were HIV positive MSM and MSM/W and predominantly African American (36.

Randomized controlled trial of mindfulness-based therapy for dyspnea in chronic obstructive lung disease.

Objectives: Patients with chronic obstructive lung disease (COPD) suffer from significant dyspnea and may benefit from complementary and alternative medicine (CAM) therapies aimed at mitigating symptoms. The objective of this study was to test the efficacy of a mindfulness-based breathing therapy (MBBT) on improving symptoms and health-related quality of life in those with COPD.

Design: We conducted a randomized controlled trial of 8-week mindfulness-based breathing therapy (MBBT) compared to support groups to test efficacy on improving symptoms and health-related quality of life in those with COPD.

Homonegativity, substance use, sexual risk behaviors, and HIV status in poor and ethnic men who have sex with men in Los Angeles.

This study evaluates associations between internalized homonegativity and demographic factors, drug use behaviors, sexual risk behaviors, and HIV status among men who have sex with men (MSM) and with men and women (MSM/W). Participants were recruited in Los Angeles County using respondent-driven sampling (RDS) and completed the Internalized Homonegativity Inventory (IHNI) and questionnaires on demographic and behavioral factors. Biological samples were tested for HIV and for recent cocaine, methamphetamine, and heroin use.

Self-monitoring of blood glucose levels in patients with type 2 diabetes mellitus not taking insulin: a meta-analysis.

Objective: To perform a meta-analysis of randomized controlled trials (RCTs) and systematic reviews evaluating the efficacy of self-monitoring of blood glucose (SMBG) levels among patients with diabetes mellitus (DM).

Study Design: Meta-analysis of RCTs among patients with DM not taking insulin comparing patients with SMBG versus those without SMBG and reporting results as change in glycosylated hemoglobin (A1C) values.

Methods: Prior systematic reviews and a PubMed search were used to identify studies.

Screening for osteoporosis in men: a systematic review for an American College of Physicians guideline.

Background: Screening for low bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA) is the primary way to identify asymptomatic men who might benefit from osteoporosis treatment. Identifying men at risk for low BMD and fracture can help clinicians determine which men should be tested.

Purpose: To identify which asymptomatic men should receive DXA BMD testing, this systematic review evaluates 1) risk factors for osteoporotic fracture in men that may be mediated through low BMD and 2) the performance of non-DXA tests in identifying men with low BMD.

Effects of stress management on PNI-based outcomes in persons with HIV disease.

A pretest-posttest, repeated-measures design was used to evaluate the effects of two stress management interventions on a battery of outcomes derived from a psychoneuroimmunological (PNI) framework. The effects of cognitive-behavioral relaxation training groups (CBSM) and social support groups (SSG) were compared with a WAIT-listed control group on the outcomes of psychosocial functioning, quality of life, neuroendocrine mediation, and somatic health. Participants were 148 individuals (119 men, 29 women), diagnosed with HIV disease; 112 (76%) completing the study groups.

The effects of preparatory sensory information on ICU patients.

Preparatory sensory information (PSI) has been found to have significant effects in reducing distress, tension, restlessness, negative moods, and anxiety, and also in reducing length of postoperative hospitalization during various threatening medical events, but no evidence has demonstrated the effect of PSI on a patient during ICU hospitalization. On the basis of Lazarus' theory, a structural equation model was developed to examine the role of the nursing intervention, PSI, as a significant factor influencing patients' processes of cognitive appraisals and coping, adaptational responses, and patient care outcomes during ICU hospitalization. The analytical model examined the net effect of PSI on outcomes, controlling for the effects of mastery, interpersonal trust, social support, socioeconomic status, severity of illness, age, and gender.

Living with a chronic wound: the voices of sufferers.

As the American population continues to age and people live longer, a growing number of individuals have chronic health problems. Of these health problems, chronic wounds are among the costliest. The focus of this research was to understand the meaning of having a nonhealing wound.

Predicting whether patients receive continuity of care after discharge from state hospitals: policy implications.

This article reports the results of a comprehensive study of predictors of factors influencing continuity of care for individuals discharged from state hospitals to communities. Continuity of care is defined and the predisposing, enabling and need factors are examined using a statewide database. The conceptual model is based on community support system principles, and it drives the research.

Clinical ladder to professional advancement program. An evolutionary process.

Since the early 1970s, clinical ladder programs have been a method of defining, recognizing, and rewarding nursing practice. As clinical practice in an institution grows and evolves, so must the program that supports the development of the practitioner. An in-depth evaluation of one clinical ladder program was conducted to determine if it was reflective of current practice.

HIV/AIDS clients' satisfaction with selected aspects of clinic nursing services.

The authors report findings from a semistructured interview study of a random sample of adult clients (N = 20) receiving care in the infectious disease clinic at a large university-affiliated state-supported teaching hospital. Clients were asked to respond to items designed to measure their satisfaction with nursing and social work services at the ID Clinic. Over all, the clients interviewed reported relative satisfaction with services received; however, clients offered substantive suggestions for continuing quality improvement.

Altered thought processes and sensory/perceptual alterations: a critique.

Concerns about the clinical usefulness of altered thought processes and sensory/perceptual alterations--and the resulting avoidance of these two diagnoses--led to a study to determine how expert nurses differentiate between the diagnoses and how the diagnoses are used in practice. The authors developed a questionnaire and mailed it to 128 members of NANDA who had identified themselves as experts in the diagnoses; sixty-six (52%) responded. Conclusions were that the defining characteristics for altered thought processes were cognitively oriented and those for sensory/perceptual alterations were perceptually oriented.

Psychiatric-mental health head nurse management concerns.

Psychiatric-mental health head nurses supervise and direct patient care, and therefore, possess a critical, front-line perspective of nursing practice problems. This article explores this perspective by interviewing four head nurses about patient care, staffing, and organizational management concerns. Interestingly, some of the findings of the study, such as head nurse concerns regarding retaining, recruiting, and motivating staff, and increasing patient acuity, already have been supported in the general nursing literature.