bluuebunny/crossref_metadata_2025_split huggingface dataset:
Literacy in the Health Care System: A Study On Open Heart Surgery Patients
Authors: Kenyon Conlin Kathy , Schumann Lorna 
Published: May 2005

PurposeTo determine if patients recovering from open heart surgery were able to read and understand written discharge instructions and further to analyze the level of difficulty of standard discharge instructions and consent forms for open heart surgery.Data SourcesAfter screening for visual acuity and efficiency, literacy was assessed with the Rapid Estimate of Adult Literacy in Medicine test (REALM) and comprehension was tested by a post‐test of five questions based on the discharge instructions. Flesch‐Kincaid scores were calculated on four sets of standard written discharge instructions and consent forms.ConclusionsResults from the study indicated that the REALM test was more accurate than the reported grade level and that reading skills are needed to understand and comprehend information needed for post‐operative care. The study further substantiated that health care facilities are not providing wrien instructional material that is within the reading level of the patient.Implications for PracticeIlliteracy can have a major impact in the health care system. Low reading skills can disempower and can prove to be costly for patients who are requiring health care services. Further investigation is needed on the impact of patients’ reading skills on the health care system.
Guidelines for the Management of Rheumatoid Arthritis 2002 Update
Authors: Goolsby Mary Jo , Newsome Grace 
Published: May 2005

AbstractRheumatoid arthritis (RA) is a progressive polyarthritis that is responsible for over nine million office visits annually. It is likely that most nurse practitioners will care for one or more patients with RA because approximately 1% of the adult population is affected by this disabling disorder. The guideline reviewed in this month's column describes the recommended care of patients who have been previously diagnosed with RA.
Parameters for the Treatment of Urticaria and Angioedema
Authors: Goolsby Mary Jo , Yates Christy 
Published: May 2005

AbstractThis month's CPG column reviews “The Diagnosis and Management of Urticaria: a Practice Parameter Part I: Acute Urticaria/Angioedema and Part II: Chronic Urticaria/Angioedema.” As many as 15%‐24% of the U.S. population may experience at least one episode of urticaria and/or angioedema in their lifetime. Evaluation and treatment is dependent on whether the urticaria/angioedema is acute or chronic because they are fundamentally different disorders. Acute urticaria is frequently self‐limited and usually caused by an allergic reaction to an identifiable agent. Chronic urticaria is usually due to an endogenous cause, one that is difficult to identify and to treat. Due to the magnitude, potential seriousness and chronicity of urticaria and angioedema, this CPG should be quite useful to nurse practitioners in a variety of settings.
Evaluating Intimate Partner Violence
Authors: Schumann Lorna , Valente Sharon M. 
Published: May 2005

PurposeTo describe the incidence, assessment, and management of intimate partner violence (IPV) from a cultural perspective emphasizing the values, strengths, and health care needs of African‐American women.Data SourcesReview of the published scientific literature, U.S. Bureau of Justice Statistics and the National Crime Victimization Survey (NCVS) supplemented with hypothetical cases.ConclusionsViolence is a social and public health emergency affecting over 10% of the population during their lives and 22% of women who are physically assaulted by an intimate. Roughly 3 million to 4.4 million women report being battered annually, although this is a low estimate. Neither gender nor age nor sexual orientation protects one from IPV. Violent crime causes 2.2 million known injuries with a huge cost in hospital days and other expenses.Implications for PracticeWomen often hesitate to report violence; health care professionals detect as few as 5% of battered women. Women suffer for months and years before accurate diagnosis. Clinicians need to be vigilant in case finding, education, prevention, and treatment. Cultural differences in values and beliefs, and behavioral norms influence evaluation, treatment, and referral.
Screening Strategies for Group B Streptococcus in the Third Trimester of Pregnancy
Authors: Schumann Lorna , Gerner Woltjen Mary 
Published: May 2005

PurposeTo identify the best screening protocol to prevent neonatal group B streptococcal (GBS) sepsis through literature review.Data SourcesSelected research articles, texts, and Internet sources.ConclusionsCenters for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG), and American College of Nurse Midwives (ACNM) have issued guidelines describing methods to identify pregnant women at risk of intrapartum transmission of GBS to their babies. Studies have been conducted to discover the superiority of one prevention method over the other but no consensus has been reached.Implications for PracticeBefore widely used prevention methods, approximately 8,000 babies each year became infected with GBS; of those, 400 died and many survivors suffered life‐long sequelae. Adoption of an appropriate protocol can prevent transmission of GBS from a colonized mother to her infant. Clinicians should implement either universal culture‐based or risk factor‐based screening guidelines for prenatal diagnosis and intrapartum prophylaxis of GBS disease.
Pathogenesis and Treatment of Rhabdomyolysis
Authors: Rupert Stacy A. 
Published: May 2005

PURPOSETo provide clinicians in primary and acute care settings with information on the evaluation, diagnosis, and treatment of rhabdomyolysis.DATA SOURCESSelected review articles from print and electronic sources, and a case study.CONCLUSIONSRhabdomyolysis is a common disorder, which may result from a large variety of diseases, trauma, or toxic insults to skeletal muscle. It is caused by skeletal muscle injury and results in the release of muscle contents (i.e., myoglobin) into the plasma. Muscular, urinary, and general internal disturbances are the three areas where signs and symptoms occur.IMPLICATIONS FOR PRACTICEClinical signs and symptoms vary widely. Associated life‐threatening complications include acute renal failure, cardiac arrhythmias and arrest, disseminated intravascular coagulation, and compartment syndrome. Early recognition and treatment in the acute phase of rhabdomyolysis are keys to successful outcomes and an excellent recovery.
Factors Influencing the Access to Prenatal Care by Hispanic Pregnant Women
Authors: Shaffer Cynthia F. 
Published: May 2005

PurposeTo explore factors influencing the access to prenatal care among Hispanic pregnant women living in the United States.Data SourcesA convenience sample of 46 Hispanic migrant pregnant women was interviewed over a 12‐month period using a set of five open‐ended questions.ConclusionsThe ability of the health care providers to communicate in Spanish, as well as the availability of culturally sensitive prenatal care were the main factors influencing the willingness of Hispanic women to access to prenatal care.Implications For PracticeWith the Hispanic population increasing in the United States, there is a need to provide culturally appropriate health care for that population; prenatal care is one of the areas of health care in demand. This study supports the findings in the literature and provides nurse practitioners a deeper understanding of the needs of Hispanic women needing prenatal care.
USPSTF Recommendations
Authors: Goolsby Mary Jo 
Published: May 2005

The United States Preventive Services Task Force (USPSTF) is convened by the U.S. Public Health Service. The set of recommendations published by the USPSTF addresses over 200 health topics on preventive measures, counseling, immunizations, and chemoprophylaxis. The 3rd edition of the recommendations is currently being released, with each statement published as it is prepared. This column reviews three of the six recommendations currently available as part of the 3rd edition on: aspirin therapy for the prevention of heart disease, screening for chlamydia, and screening for skin cancer.The April column will review a comprehensive guideline on adult obesity. Readers are encouraged to submit ideas or manuscripts for this column to column editor Mary Jo Goolsby, EdD, MSN, APRN, ANP‐C, by e‐mail at mjgoolsby@aanp.org.
The Relationship of Actual Height Loss with Health‐Seeking Behaviors and Risk Factors in Perimenopausal and Menopausal Women
Authors: Twiss Janice J. , Dillon Annette L. , Konfrst Jill M. , Stauffer Jenda , Paulman Audrey 
Published: May 2005

PurposeTo explore whether there is a difference in the perceived height and actual height in the perimenopausal or menopausal woman and discover the difference's effect on osteoporosis health‐seeking preventive behaviors and risk factor awareness.Data SourcesSixty‐three perimenopausal and menopausal women, aged 45–70 years, who presented three Midwestern clinics for their annual physical exam. Data were collected with The Osteoporosis Questionnaire, which included the Osteoporosis Risk Questionnaire, Health‐ O‐Meter height measuring stick, tape measure with inch‐rule for arm span measurements, and balance scale for weight.ConclusionsThere were a significant relationship between actual height loss and osteoporosis risk factors (r= 0.41595, p=0.0007) and a trend for a relationship between adjusted height loss and osteoporosis risk factors (r=0.2407, p=0.0574).Implications For PracticeDue to the great expense of current testing for bone mass density loss, the results of this study may help clinicians more readily identify markers for increased risk of osteoporosis through simple height measurements and osteoporosis risk factor assessments during annual visits.
Identification, Evaluation, and Treatment of Overweight and Obese Adults
Authors: Goolsby Mary Jo , Blackwell James 
Published: May 2005

AbstractThis month's CPG review is on overweight and obese adults. With an estimated 97 million or more adults in the United States who are overweight or obese and as the second leading cause of preventable death in the United States, this guideline is expected to be of wide interest to nurse practitioners.
Trends in Mental Health: Implications for Advanced Practice Nurses
Authors: Puskar Kathryn R. , Bernardo Lisa 
Published: May 2005

PurposeTo examine current trends in mental health care for vulnerable populations and suggest how advanced practice nurses (APNs) can incorporate mental health care into primary care practice.Data SourcesOriginal research and evidence‐based clinical articles, government publications, and professional practice guidelines.ConclusionsVulnerable populations, such as racial and ethnic minorities, adults with chronic mental illness, the elderly, the incarcerated, and those living in rural areas have long been ignored as recipients of quality, integrated health care services. There is a compelling need for APNs to participate in the integrated delivery of physical and mental health care to all Americans, especially to vulnerable populations.Implications for PracticeUnder the umbrella of advanced practice nursing, a variety of nurse practitioners (NPs) and clinical nurse specialists (CNSs) can offer a holistic approach to the provision of evidencebased health care in a wide variety of settings to an array of vulnerable and underserved people. By serving on provider panels, partnering with consumer groups, and advocating for the unmet health needs of vulnerable populations, APNs can have a positive impact on the health care delivery system.
Increasing Awareness of Asthma and Asthma Resources in Communities on the Southwest Border
Authors: Ochsner Anita K. , Alexander Jackie L. , Davis Adelina 
Published: May 2005

PurposeTo provide outpatient asthma education for children and families along the southwest border of the U.S. and to study the effectiveness of a southwest border hospital's in‐house asthma educational program.Data Sources(1). “Increasing the Knowledge Base of Asthmatics and Their Families through Asthma Clubs along the Southwest Border.” (2). American Lung Association. (3) National Institutes of Health, National Heart, Lung and Blood Institute. (4) Referrals from a southwest border hospital.ConclusionsOnly two of 23 patients referred for asthma follow‐up were readmitted to hospital and/or emergency care during the following year. Large group teaching pretest‐posttest score means for 3,429 fourth and fifth grade students revealed a 23% increase in asthma knowledge. Small follow‐up groups of students received in‐depth asthma education.Implications for PracticeEffectiveness of hospital inpatient asthma education combined with outpatient family follow‐up was supported. An additional finding was that southwest border families are more receptive to visits arranged with a school nurse in their children's school than to home visits from primary care clinic nurses.
Implementing a Smoking Cessation Program for Pregnant Women Based on Current Clinical Practice Guidelines
Authors: Buchanan Lynne 
Published: May 2005

PurposeTo describe the U.S. Department of Health and Human Services clinical practice guideline for treating tobacco use and dependence and demonstrate how the guideline was utilized in a pilot program for a small sample of pregnant women (n=20) to help them decrease smoking.Data SourcesA convenience sample of 20 pregnant women was recruited from a health maintenance organization at their initial prenatal contact either by telephone or in person. A comparison group of pregnant women (n=28) was used for analysis of outcomes.ConclusionsClinical results showed better outcomes for women in the pilot program when compared to a similar group who did not participate in the program. There was a statistically significant difference between the two groups in average number of cigarettes smoked per day at delivery and two weeks after delivery with pilot program participants reporting less smoking (p<.05). Women in both groups showed a pattern of returning to smoking after delivery of the baby.Implications for PracticeAlthough a few tobacco users achieve permanent abstinence in first or second attempts, the majority continue to use tobacco for many years and typically cycle through many lapse and relapses before permanent abstinence. Ambulatory care systems need to be developed and funded to treat tobacco use and dependence over the life span. Recognition of the chronic nature of the problem and development of long term care delivery systems are needed to assist clients to achieve goals of permanent abstinence and better personal and family health. This cycle of lapse and relapse before permanent abstinence is typical and demonstrates the chronic nature of tobacco use and dependence and the need for long term follow‐up.
Bulimia Nervosa: Knowledge, Awareness, and Skill Levels Among Advanced Practice Nurses
Authors: Dichter Jacquelin R. , Cohen Jayne , Connolly Phyllis M. 
Published: May 2005

PurposeTo examine the knowledge, awareness, and self‐perceived skill levels regarding bulimia nervosa (BN) among advance practice nurses (APNs) caring for young female patients.Data SourcesTwo hundred APNs of various nurse practitioner (NP) specialties were surveyed with a mailed questionnaire. One hundred and twenty‐ one (61%) surveys were returned and analyzed.ConclusionsResults demonstrated that APNs are knowledgeable and aware about BN. There were several statistically significant relationships among awareness and self‐perceived skill levels. Pediatric NPs were found to be the most aware of BN in their young female patients.Implications for PracticeThe incidence of eating disorders is on the rise. Bulimia nervosa, a common secretive illness, poses a significant challenge for APNs potentially leading to missed diagnosis. There is a paucity of research exploring this issue. Study findings provide evidence to enhance curricula on eating disorders in academic and continuing education programs and guidance for future research.
Herpes Zoster Ophthalmicus: How Is It Identified and Treated?
Authors: Schumann Lorna , Temple Jeffery J. 
Published: May 2005

PurposeTo describe herpes zoster ophthalmicus in relation to the anatomy, pathophysiology, course, diagnostic considerations, and management for the primary care provider.Data SourcesActual case study supplemented with an extensive review of current scientific and psychosocial literature.ConclusionsHerpes zoster ophthalmicus (HZO) is an extension of a herpes zoster (HZ) infection involving the fifth cranial (trigeminal) nerve, which results from the reactivation of a latent varicella virus among individuals who had contracted a varicella infection sometime within their lifespan.Implications for PracticeDue to the vague presenting symptomology of HZO, many patients may be misdiagnosed lessening the chance for prompt diagnosis and therapeutic intervention. Educational awareness, listening to psychosocial concerns of the patients, and immediate referral can decrease potential chronic side effects of the disorder.
Listening to Women: Culturally Tailoring the Violence Prevention Guidelines from the Put Prevention Into Practice Program
Authors: Shoultz Jan , Phillion Nancy , Noone Joanne , Tanner Barbara 
Published: May 2005

PurposeTo develop five reliable and valid (culturally tailored) guidelines focused on the prevention of violence as presented in the violence prevention guideline of the Put Prevention into Practice Clinician's Handbook on Preventative Services (PPIP).Data SourcesThe data collection for this qualitative, descriptive design of naturalistic inquiry was focus group interviews with five different ethnic groups of women (Caucasian, Filipino, Hawaiian, Japanese and Hispanic) using a semi‐structured interview guide.ConclusionsThe women interviewed provided a variety of suggestions for adaptations to the guideline. Cultural similarities and differences are presented. Development of a nonjudgmental and trusting relationship is key to disclosure.Implications for PracticeViolence against women is recognized as a major public health problem. Little is known about the effectiveness of standardized interventions such as those contained in the PPIP Handbook. Even less is known about the efficacy of such protocols within culturally diverse populations. Providers should consider adaptation of the guideline based on the individual relationship with the client. The next phase of this research is to implement the culturally tailored adaptations of these guidelines and test their effectiveness.
Alzheimer's Disease Management
Authors: Goolsby Mary Jo , Blackwell James 
Published: May 2005

This month's CPG review is on Alzheimer's disease management. Currently, four million people in the United States have been diagnosed with Alzheimer's disease and this incidence is expected to become greater as the population ages. This guideline should therefore be of great interest to nurse practitioners who either treat this population or may be personally affected in some way by this condition.James Blackwell, MS, APRN, BC, is the Disease Management Coordinator of Blue Cross/Blue Shield of South Carolina. The views expressed in this article are those of the author and do not necessarily reflect the views of Blue Cross and Blue Shield of South Carolina or any of its subsidiaries.
Contraceptive Efficacy and Patient Acceptance of Lunelle
Authors: Freeman Sarah 
Published: May 2005

PurposeTo review the efficacy, safety, and patient acceptance of the LunelleTMmonthly contraceptive injection and to raise awareness of this new contraceptive in the United States.Data SourcesWorldwide scientific literature, reports of clinical trials, and manufacturers’ product information and guidelines.ConclusionsLunelleTM is a combined hormonal method with a safety/tolerability profile comparable to that of oral contraceptives (OC) and a high efficacy rate and provides a rapid return of fertility after discontinuation. Moreover, LunelleTM was well accepted in a large clinical trial, with satisfaction levels similar to those of new‐start OC users.Implications for PracticeOral contraceptives are the most popular hormonal birth control method in the United States; however, typical use is associated with higher failure rates than those observed with perfect use because of poor compliance. Poor compliance has been attributed in part to the need for daily administration. A new contraceptive method that does not require daily administration and is readily reversible may be suitable for many women, resulting in better overall efficacy.
Migraine and Its Treatment with 5‐HT1B/1D Agonists (Triptans)
Authors: Schumann Lorna , Moriarty‐Sheehan Maureen 
Published: May 2005

PurposeTo review the epidemiology and clinical features of migraine and to discuss the use of the 5‐HT1B/1D agonists (triptans) in the treatment of moderate to severe migraine.Data SourcesA Medline search was conducted for relevant recent articles on migraine and the efficacy and safety of the triptans.ConclusionsWith the advent of a standardized classification system for headache to simplify migraine diagnosis, new approaches to treatment, and effective new therapies, such as the triptans, many patients have obtained significant relief from the pain and disability associated with migraine.Implications for PracticeThe key to successful migraine management is to provide the most effective treatment at the earliest possible time. Under the step‐care approach to migraine management, the mildest and most conservative treatment was recommended as a first step, without regard for the degree of the patient's pain or disability. This approach has been replaced by stratified care, in which migraine management is based on the severity of the patient's pain and disability. Under the stratified approach, patients with moderate or severe migraine would be prescribed effective migraine‐specific drugs, such as the triptans, as first‐line therapy.
Decision‐Making in Children with Asthma and their Parents
Authors: Meng Anne , McConnell Susan 
Published: May 2005

PurposeTo learn how children with asthma and their parents make treatment‐related decisions.Data SourcesVerbatim transcripts of focus group interviews of 28 school age children with asthma and their parents. Children had attended an educationally based asthma camp program. Questions related to choices parents and children made regarding implementation of their asthma treatment plans both, at home and at school.ConclusionsParents and children made many non‐adherence decisions especially with respect to preventive aspects of the treatment plan. Symptoms were the driving force for children's decisions. Parents and children had concerns about implementing the management plan school. Parents and children may not perceive asthma treatment options as true choices, thus affecting motivation for adherence.ImplicationsPractitioners need to form partnerships with parents and children in developing treatmentgoals. Goals should focus on achievement of normal daily activities. Asthma education needs to be concrete and include school personnel. Practitioners need to give families positive, informational feedback.