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By P. Harek. Bowie State University. 2018.

The items were derived from the car- study purchase suprax 200mg mastercard, found she could not approach analysis of the ing theory order 100 mg suprax amex. Three negatively worded items (abrupt purchase suprax 100 mg with mastercard, transcripts naively—that is safe 100 mg suprax, with no preconceived emotionally distant, and insulting) were dropped notions, as would be expected in the conduct of due to minimal variability across all of the data sets. Hence, she employed For the counselors at one, five, and eleven weeks both deductive and inductive content analytic tech- postloss, Chronbach alphas were. The lower reliability estimates question, “Is there evidence of caring as defined by were because the counselors’ caring professional Swanson [1991] on the part of the nurse coun- scores were consistently high and lacked variability selors? Phrases were Noteworthy findings include the following: coded for which (if any) of the five caring processes were represented by the emic utterances. Each counselor had a full range of presession counselor statement was then further coded for feelings, and those feelings/moods were, as which subcategory of the five processes was repre- might be expected, highly intercorrelated. The caring professional scores were extremely ance of the nurse counselor could be accounted for high for both counselors, indicating that, over- by one of the subcategories. One of the counselors was a psychiatric nurse by completed a Profile of Mood States (McNair, Lorr, background. In the first part, a meta-analysis of 18 quan- case, depression and confusion) were signifi- titative studies of caring actions was performed. During Session I, women discussed in-depth provided; (2) knows how to give shots and manage what the actual events of miscarrying felt like. By contrast, the that her own vulnerabilities were a bit less top five caring behaviors valued by nurses were: (1) veiled. The second go out in public as a woman who had miscar- part of the caring actions summary was a review of ried), was the only session in which the other 67 interpretive studies of how caring is expressed counselor’s vulnerabilities came through. These counselor, having just gone through a divorce, qualitative studies were classified under Swanson’s was probably least able to hide her presession caring processes, thus lending credibility to caring moods (depression, (p. In summary, this literary notably, there was an association between this meta-analysis clarified what “caring” means, as the counselor’s presession tension and the client’s term is used in nursing, and validated the general- caring professional rating (p. Analysis of Caring Couples Miscarriage Another recent project was an in-depth review of the literature. This literary meta-analysis is pub- Healing Project lished elsewhere (Swanson, 1999). Proposed were five make a difference in men and women’s healing after domains (or levels) of knowledge about caring in miscarriage. I believe that these domains are hierarchi- is to compare the effects of nurse caring (three cal and that studies conducted at any one domain nurse counseling sessions), self-caring (three (e. The first domain in- bined caring (one nurse counseling plus three cludes descriptions of the capacities or characteris- videotapes and journals), and no intervention tics of caring persons. These are the values nurses hold that lead partners (husbands or male mates) in the first year them to practice in a caring manner. All intervention materials have scribes the conditions (nurse, patient, and organi- been developed based on the Miscarriage Model zational factors) that enhance or diminish the and the Caring Theory. Nursing as informed caring for the well- long way to go to make a case for the educa- being of others. What’s known about caring in nursing importance of nurses practicing in a caring science: A literary meta-analysis. The effects of caring, measurement, ing in terms of time, money, and personal en- and time on miscarriage impact and women’s well-being in ergy expended. Research-based practice with women under the framework of caring in order to tie who miscarry. The unborn one: The human (nurses and clients), to the cultural contexts experience of miscarriage (Doctoral dissertation, University of Colorado Health Sciences Center, 1983). Miscarriage: A new under- and communities experience when living standing of the mother’s experience.

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Cutaneous infections are sis) cheap 100mg suprax with amex, Cryptococcus neoformans (which causes cryptococcosis) order suprax 200mg otc, treated with ointment and vaginitis is treated by suppositories purchase 200 mg suprax fast delivery. Coccidioides immitis (which causes coccidioidomycosis) and Sporotrichum schenckii (which causes sporotrichosis) discount 100mg suprax with visa. Amphotericin is insoluble in water, but can Nystatin can cause nausea and diarrhoea when large doses be complexed to bile salts to give an unstable colloid which can are administered orally. Amphotericin B is normally given as an intravenous infusion given over four to six hours. Key points Several liposomal or lipid/colloidal complex amphotericin preparations have now been formulated, and are less toxic (par- Polyene antifungal drugs ticularly less nephrotoxic), but more expensive than the stand- • Wide spectrum of antifungal activity, fungicidal; makes ard formulation. Topical amphotericin lozenges or suspension are • Amphotericin is used intravenously for deep-seated and used for oral or pharyngeal candidiasis. Mechanism of action • Intravenous amphotericin is toxic, causing fever, chills, hypotension during infusion, nephrotoxicity, electrolyte Amphotericin is a polyene macrolide with a hydroxylated abnormalities and transient bone marrow suppression. The lipophilic amphotericin is reduced by using the liposomal/ surface has a higher affinity for fungal sterols than for choles- lipid/micellar formulations. They are used topically and are • reversible nephrotoxicity; this is dose dependent and active both against dermatophytes and yeasts (e. It results from vasoconstriction and Some imidazoles are also used systemically, although they tubular damage leading to acute renal impairment have limited efficacy and significant toxicity. Mechanism of action of azoles (imidazoles and • tubular cationic losses, causing hypokalaemia and triazoles) hypomagnesaemia; • normochromic normocytic anaemia due to temporary Imidazoles competitively inhibit lanosterol 14-α-demethylase marrow suppression is common. This disrupts the acyl chains of fungal membrane phos- Poor gastro-intestinal absorption necessitates intravenous pholipids, increasing membrane fluidity and causing administration for systemic infections. Amphotericin distrib- membrane leakage and dysfunction of membrane-bound utes very unevenly throughout the body. The t1/2 is occurs due to mutations in the gene encoding for lanosterol 18–24 hours. Breast milk concentrations are inhibits testosterone and cortisol synthesis) and because it similar to those in plasma and fluconazole should not be used interacts adversely with many drugs. The use and properties of more commonly used imidazoles Pharmacokinetics are listed in Table 45. Fluconazole is well absorbed after oral administration and is widely distributed throughout the body. Triazole drugs fluconazole mean elimination t is 30 hours in patients with 1/2 work by the same mechanism as imidazoles but have a wider normal renal function. However, Aspergillus species nel blockers, ciclosporin, docetaxel and, importantly, war- are resistant and resistant Candida species are problematic in farin. Fluconazole is used clinically will increase during concomitant treatment with fluconazole. It is administered orally or Itraconazole and voriconazole are available as oral and par- intravenously as a once daily dose. Oral bioavailability is good for both Adverse effects agents, but intravenous use is indicated for severe fungal infec- tions. The antifungal spectrum is similar to that of fluconazole Adverse effects include: and is broad. The mean itraconazole t1/2 is 30–40 hours and • hepatitis (rarely, hepatic failure). Induces its own infections metabolism Miconazole Oral Candida (topical therapy for Oral gel, four times daily Nausea and Systemic absorption is ringworm, Candida and pityriasis 2% cream or powder vomiting, rashes. Mechanism of action Key points Echinocandins are non-competitive inhibitors of 1,3-β-D glucan Azole antifungal drugs synthase, an enzyme necessary for synthesis of a glucose poly- mer crucial to the structure and integrity of the cell walls of • Relatively wide spectrum of antifungal activity, fungistatic, but fungicidal with higher concentrations. Fungal cells unable to synthesize this polysaccha- • Impair ergosterol biosynthesis by inhibiting ride cannot maintain their shape and lack adequate rigidity to lanosterol 14-alpha-demethylase (fungal cytochrome resist osmotic pressure, which results in fungal cell lysis.

Riding the wave: South Africa’s contri- bution to ethnopharmacological research over the last 25 years discount 100mg suprax with amex. Policy and public health perspectives on tradi- tional buy suprax 200 mg fast delivery, complementary and alternative medicine: an overview order suprax 200 mg without a prescription. In: Bodeker proven suprax 100 mg, G, Burford G (eds), Traditional, Complementary and Alternative Medicine: Policy and public health perspectives. Manchester: Manchester University Press in association with the International African Institute, 1986. The professionalisation of indigenous medicine: a comparative study of Ghana and Zambia. Manchester: Manchester University Press in association with the International African Institute, 1986: 117–135. Manchester: Manchester University Press in association with the International African Institute, 1986: 151–62. Report of the Inter-Regional Workshop on Intellectual Property Rights in the Context of Traditional Medicine. Proceedings of an International Workshop on Traditional Knowledge, Panama City, 21–23 September 2005. A review of the taxonomy, ethnobotany, chemistry and pharmacology of Sutherlandia frutescens (Fabaceae). Galanthamine: a randomised double-blind, dose comparison in patients with Alzheimer’s disease. Antidiabetic screening and scoring of 11 plants traditionally used in South Africa. In vitro antiplasmodial activity of medicinal plants native to or naturalised in South Africa. The distribution of mesembrine alkaloids in selected taxa of the Mesembryanthemaceae and their modification in the Sceletium derived ‘kougoed’. Antimycobacterial activity of 5 plant species used as traditional medicines in the Western Cape Province (South Africa). Uses and abuses of in vitro testing in ethnopharmacology: visualizing an elephant. A pharmacognostical study of 26 South African plant species used as traditional medicines. The African cherry (Prunus africana): can lessons be learned from an over- exploited medicinal tree? Acute toxicity associated with the use of South African traditional medicinal herbs. Clinical and analytical aspects of pyrrolizidine poisoning caused by South African traditional medicines. Screening of medicinal plants used in South African traditional medicine for genotoxic effects. Searching for a Cure: Conservation of medicinal wildlife resources in east and southern Africa. In: Bodeker G, Burford G (eds), Traditional, Complementary and Alternative Medicine: Policy and public health perspectives. In: Bodeker G, Burford G (eds), Traditional, Complementary and Alternative Medicine: Policy and public health perspectives. An Africa-wide Overview of Medicinal Plant Harvesting, Conservation and Health Care. A brief overview of other similar traditional medicine practices is also included. All healthcare providers, particularly those who practise in areas with substantial Chinese immigrant populations, will find it useful to have some background knowledge of this topic. Written in the form of a discourse between Huangdi and his ministers on the nature of health, it contains a wealth of knowledge, including aetiology, physiology, diagnosis, therapy and prevention of disease, as well as an in-depth investigation of such diverse subjects as ethics, psychology and cosmology. Entitled The Classic of Difficult Issues, it discusses the origins of the nature of illness, describes an innovative approach to diagnosis and outlines a system of therapeutic needling.

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Derdiarian’s early research tested an instru- changes in other subsystems (Derdiarian buy cheap suprax 200mg online, 1990) generic suprax 200mg with amex. She focused on of cancer patients (Derdiarian buy suprax 200mg otc, 1983; Derdiarian & the nurses’ assessment of the patient using the Forsythe suprax 100mg discount, 1983). The re- approach expanded the view of nursing knowledge sults demonstrated by the instrument possessed from exclusively client based to knowledge about content validity, strong internal consistency, and the context and practice of nursing that is model thus strong reliability. Derdiarian also found that a the Johnson model’s eight behavioral subsys- model-based, valid, and reliable instrument could tems. The study also served to further validate her improve the comprehensiveness and the quality of instrument. The measure Derdiarian’s body of work reflects the complex- can be taken as an indicator of the construct of “be- ity of nursing’s knowledge as well as the strategic havioral set. Her arti- work of relations that were tied to observables and cle (Derdiarian, 1991) demonstrated the clear rela- were therefore empirically testable. This validation tionship between Johnson’s theory and nursing study linked a particular measure, the Derdiarian practice. It provided identify the most common nursing diagnoses of evidence that the measure exhibited, at least in part, hospitalized geopsychiatric patients. They found the network of relations derived from the theory of that 30 percent of the diagnoses were related to the the construct. My goal was to determine the causes of instability within and between subsystems (e. My first study (Holaday, 1974) compared the achievement behavior of chronically ill and healthy children. The study showed that chronically ill children differed in attributional tendencies when compared with healthy chil- dren and showed that the response patterns differed within the chronically ill group when compared to certain dimensions (e. Males and children diagnosed at birth attributed both success and fail- ure to the presence or absence of ability and little to effort. The results indicated behavioral system imbalance and focused my attention on interventions directed toward set, choice, and action. The next series of studies used the concept of “behavioral set” and examined how mothers and their chron- ically ill infants interacted (Holaday, 1981, 1982, 1987). Patterns of maternal response provided information re- lated to the setting of the “set goal” or behavioral set; that is, the degree of proximity and speed of maternal response. Mothers with chronically ill infants rarely did not respond to a cry indicating a narrow behavioral set. Further analysis of the data led to the identification of a new structural component of the model-conceptual set. A person’s conceptual set was defined as an organized cluster of cognitive units that were used to inter- pret the content information from the preparatory and perseveratory sets. A conceptual set may differ both in the number of cognitive units involved and in the degree of organization exhibited. The various cognitive units that make up a conceptual set may vary in complexity depending on the situation. Three levels of conceptual set have been identified, ranging from a very simple to a complex “set” with a high degree of connectedness be- tween multiple perspectives (Holaday, 1982). Thus, the conceptual set functions as an information collection and processing unit. Examining a person’s set, choice, and conceptual set offered a way to examine issues of indi- vidual cognitive patterns and its impact on behavioral system balance. The most recent study (Holaday,Turner-Henson, & Swan, 1997) drew from the knowledge gained from pre- vious studies. Our results indicate that it was possible to determine the impact of a lack of functional requirements on a child’s actions and to identify behavioral system imbalance and the need for specific types of nursing intervention. The goal of my research program has been to describe the relations both among and within the subsystems that make up the integrated whole and to identify the type of nursing interventions that restore behavioral sys- tem balance. American Nursing Diagnosis Association) diag- ulty; however, no published material is available noses, which demonstrated considerable overlap. The evaluating the quality of nursing care (Dee & primary focus of the program would be the study Auger, 1983).

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The contribution of personality to adult concept and self-care in children with cancer buy discount suprax 100 mg on line. International research project to test Nephrology Nurses Association Journal cheap suprax 200 mg overnight delivery, 18 suprax 200 mg fast delivery, 45–47 order suprax 100mg with visa, 53. Concept for- of scientific session of the 29th Biennial Convention of Sigma malization in nursing: Process and product (2nd ed. Structuring nursing practice based on Orem’s ated by chemotherapy patients in response to fatigue. Family culture, family resources, depend- Nursing Administration Quarterly, 15(3), 72–78. A case study: Perspectives on a self-care nary artery bypass surgery, a prospective study. Primiparas’ prenatal concern for learn- effects: A programme of inquiry within Orem’s self-care ing infant care. Nursing assessment for risk of homicide Dutch version of the appraisal of self-care agency scale: with battered women. Self-care actions taken by older adults for in- care agency in people beginning a weight loss program. Response to “Predictors of children’s self- of elderly client and nurse perceptions of the clients’ self-care care performance: Testing the theory of self-care deficit. Perceptions of chemotherapy: An assessment of nursing interventions— self-care in Sweden: A cross-cultural replication. Measuring informational intervention for chemotherapy knowledge and self-care behavior. Using self-care the- dational capabilities, and urinary incontinence self-care in ory to guide nursing management of the older adult after hos- women. Appraisal of self-care agency scale: Validity and strument to measure exercise of self-care agency. The nursing preparation of stoma patients for home visits to elderly people by community nurses in the self-care. Assessing and teaching self-care cancer-related fatigue: Refinement and evaluation of Orem’s to youths with diabetes mellitus. Validation of an instrument to measure ex- Conceptualizations and operationalizations. Journal of Adolescent acting variable with self-care agency: Testing a theoretical Health Care, 9, 55–60. Journal of ment to measure mothers’ performance of self-care activities Gerontological Nursing, 17(6), 39–43. A nursing practice theory in three parts, independent elderly: Self-concept affects well-being. Archives of Psychiatric Nursing, 6, ated by chemotherapy patients in response to fatigue. Dependent care, caregiver burden, and tor analysis of Bickel and Hanson’s questionnaire. The health-promoting self-care system concept of women’s self-care developed within Orem’s self-care model: Directions for nursing research and practice. Journal deficit theory: Instrumentation, psychometric evaluation and of Advanced Nursing, 15(10), 1162–1166. Malinski Introducing the Theorist Introducing the Theory Separate Theories Implicit in Science of Unitary Human Beings Summary Bibliography Introducing the Theorist guides practice to promote health and well-being for humankind. Rather, it is the use of nursing knowledge tists, was a staunch advocate for nursing as a basic for human betterment” (Rogers, 1994a, p. She believed that the art of practice could Rogers identified the unitary human being and be developed only as the science of nursing evolved. She repeatedly need to differentiate skills, techniques, and ways of emphasized the need for nursing science to encom- using knowledge from the body of knowledge that pass beings in space as well as on Earth. Rogers’ Science of Unitary Human Beings 161 this visionary who introduced a new worldview to (1964), and the landmark An Introduction to the nursing?

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