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Physical Mobility (physical + mobility)
Selected AbstractsIndividual-based Computational Modeling of Smallpox Epidemic Control StrategiesACADEMIC EMERGENCY MEDICINE, Issue 11 2006Donald S. Burke MD In response to concerns about possible bioterrorism, the authors developed an individual-based (or "agent-based") computational model of smallpox epidemic transmission and control. The model explicitly represents an "artificial society" of individual human beings, each implemented as a distinct object, or data structure in a computer program. These agents interact locally with one another in code-represented social units such as homes, workplaces, schools, and hospitals. Over many iterations, these microinteractions generate large-scale macroscopic phenomena of fundamental interest such as the course of an epidemic in space and time. Model variables (incubation periods, clinical disease expression, contagiousness, and physical mobility) were assigned following realistic values agreed on by an advisory group of experts on smallpox. Eight response scenarios were evaluated at two epidemic scales, one being an introduction of ten smallpox cases into a 6,000-person town and the other an introduction of 500 smallpox cases into a 50,000-person town. The modeling exercise showed that contact tracing and vaccination of household, workplace, and school contacts, along with prompt reactive vaccination of hospital workers and isolation of diagnosed cases, could contain smallpox at both epidemic scales examined. [source] Agreement between dementia patient report and proxy reports using the Nottingham Health ProfileINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2004F. Boyer Abstract Objective The aim of the study was to examine the agreement between patient reports and their proxy reports (family and care provider proxies) on Health Status in a sample of patients with dementia. Method Ninety-nine patients with mild to moderate dementia and proxies completed the 38-item Nottingham Health Profile (NHP) questionnaire. Results Completion rates for the different NHP dimensions ranged from 78 to 90% for the dementia subjects. Inter-rater agreement between different proxies and subject was from moderate to good for physical assessment (ICCs from 0.54 to 0.78 for physical mobility scales). Patient/family proxy concordance was moderate to good for five out of six dimensions (physical mobility, social isolation, pain, energy, sleep) and poor for emotional reaction. Family proxies systematically reported lower functioning than did patients in the four subscales assessing: physical mobility (p,<,0.0001), energy (p,<,0.005), social isolation (p,<,0.01) and sleep (p,<,0.03). Care provider proxies only estimated physical mobility as lower (p,<,0.0001). Conclusion Age and physical status of the patient significantly affected agreement in patient-care provider proxy ratings. Thus, caution is appropriate when resorting to proxies to estimate the Health Status of a dementia patient. Copyright © 2004 John Wiley & Sons, Ltd. [source] Nursing Diagnosis in Medical-Surgical PatientsINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Márcia Paschoalina Volpato PURPOSE. To identify nursing diagnoses identified in patients in a medical-surgical unit. METHODS. Data were collected through interviews and physical examination of 60 patients on a female ward in order to formulate NANDA diagnoses. The data collection tool was based on Gordon's 11 Functional Health Patterns. Four researchers with medical-surgical nursing expertise reached the nursing diagnosis through consensus. FINDINGS. A total of 338 diagnoses were identified from 49 different categories. Nineteen categories were identified in more than 10% of the sample: risk for infection (58%), pain (50%), constipation (42%), activity intolerance (35%), sleep pattern disturbance (28%), altered physical mobility (27%), impaired skin integrity (27%), fatigue (25%), sexual pattern dysfunction (23%), anxiety (23%), risk for ineffective manipulation of therapeutic regimen (20%), risk for trauma (20%), risk for impaired skin integrity (18%), ineffective coping (18%), altered nutrition: more than body requirements (12%), impaired communication (12%), urinary incontinence (10%), fluid volume excess (10%), and altered nutrition: less than body requirements (10%). The most frequent diagnoses related to Health Functional Patterns were identified in health control and perception, with 28% of the 338 formulated diagnoses, activity-exercise and nutritional-metabolic with 20% each. CONCLUSIONS. There was great diversity in the quality of the reported needs in the studied sample, which demands extensive knowledge and a wide range of abilities to identify needs as well as implement care in the affected patients. Studies such as this one will enhance delineation of the nursing knowledge base in order to justify allocation of human resources in specific areas. [source] Chronic Pain: Nursing Diagnosis or Syndrome?INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 4 2001Diná Almeida Lopes Monteiro Cruz PhD PROBLEM. To explore the existence of a pattern of nursing diagnoses that represents a chronic pain syndrome. METHODS. The nursing diagnoses of 68 oncologic and 46 nononcologic patients with chronic pain were submitted to univariate and multivariate analyses. Diagnoses ranked above the 75th percentile, without association with pain etiology, and presenting a pattern in cluster analyses and multidimensional scaling was accepted as possible components of chronic pain syndrome. FINDINGS. The possible components of chronic pain syndrome were disturbed sleep pattern,a constipation or risk for constipation, deficient knowledge,a impaired physical mobility, and anxiety/fear. CONCLUSIONS. Although a pattern of diagnoses has been proposed, confirmation will require further studies and the exploration of the clinical usefulness of the concept of chronic pain as a syndrome. PRACTICE IMPLICATIONS. Increased skill in the assessment and understanding of chronic pain can result in improved relief strategies. Douleur chronique: Diagnostic infirmier ou syndrome? PROBLÈME. Explorer l'existence d'un regroupement de diagnostics infirmiers représentant le syndrome de douleur chronique (SDC). MÉTHODES. Les diagnostics infirmiers présents chez 68 patients cancéreux et 46 patients non-cancéreux, souffrant de douleur chronique furent soumis à des analyses unidimensionnelles et multidimensionnelles. Les diagnostics qui furent retenus comme composantes possibles du SDC se situaient au dessus du 75e percentile, n'étaient pas associés à l'étiologie et représentaient un ensemble dans les analyses de regroupement et l'échelle multidimensionnelle. RÉSULTATS. Les composantes possibles du SDC furent perturbation des habitudes de sommeil, constipation ou risque de constipation, manque de connaissances, altération de la mobilité et anxiété/peur. CONCLUSIONS. Même si un schéma de diagnostics infirmiers a été proposé, il faudrait encore entreprendre plusieurs recherches et explorer l'utilité clinique du concept syndrome de douleur chronique, avant de confirmer la pertinence de ce syndrome. IMPLICATIONS PRATIQUES. L'amélioration de l'évaluation et de la compréhension de la douleur chronique peut conduire à de meilleures stratégies pour soulager la douleur. PROBLEMA. Explorar a existência de um padrão de diagnósticos de enfermagem que represente uma síndrome de dor crônica. MÉTODOS. Diagnóstics de enfermagem de 68 pacientes com dor crônica oncológica e 46 pacientes com dor crônica não oncológica foram submetidos a análises univariadas e multivariadas. Os diagnóstics posicionados acima do Percentil 75, sem associação com a etiologia da dor e que apresentaram um padrão na Análise de Cluster e no Escalonamento Multidimensional foram aceitos como possíveis componentes da síndrome de dor crónica. RESULTADOS. Os possíveis componentes da síndrome de dor crônica foram: distúrbio do padrão de sono, cnstipação ou risco para constipação, déficit de conhecimento, mobilidade física prejudicada e ansiedade/medo. CONCLUSÕES. Apesar de um padrão de diagnósticos ter sido proposto, a sua confirmação requer outros estudos e a exploração da utilidade clínica de se conceituar a dor crônica como uma síndrome. IMPLIAÇÕES PRÁTICAS. Melhorar a compreensão e as habilidades na avaliação da dor crônica pode resultar em melhores estratégias de alívio. Dolor crónico: Diagnóstico enfermero o síndrome? PROBLEMA. Explorar la existencia de un patrón diagnóstico de enfermería que represente el síndrome de dolor crónico (SDC). MÉTODOS. Los diagnósticos enfermeros de 68 pacientes oncológicos y 46 no-oncológicos con dolor crónico, se sometieron a análisis variable y multivariable. Se aceptaron como posibles componentes del SDC, los diagnósticos que estaban sobre el percentil 75, sin asociación con etiología de dolor y que presentaban un patrón agrupado al hacer el análisis y en la escala multidimensional. RESULTADOS. Los posibles componentes de SDC fueron alteración del patrón del sueño, estreñimiento o riesgo de estreñimiento, déficit de conocimientos, trastorno de la movilidad física y ansiedad/temor. CONCLUSIONES. Aunque un patrón de diagnósticos ha sido propuesto, la confirmación requerirá que se llevan más allá los estudios y la exploración de la utilidad clínica del concepto del dolor crónico, como un síndrome. IMPLICACIONES PARA LA PRÁCTICA. Mejorar la habilidad en la valoración y comprensión del dolor crónico pueden producir mejoras en las estrategias de alivio. [source] Predictors of Worsening of Patients' Quality of Life Six Months After Coronary Artery Bypass SurgeryJOURNAL OF CARDIAC SURGERY, Issue 6 2008Vladan Peric M.D. Methods: We studied 208 consecutive patients, who underwent elective CABG. The Nottingham Health Profile Questionnaire part 1 was used as the model for quality of life determination. The questionnaire contains 38 subjective statements divided into six sections: physical mobility, social isolation, emotional reaction, energy, pain, and sleep. We distributed the questionnaire to all patients before CABG and six months after CABG. One hundred ninety-two patients filled in the postoperative questionnaire. Results: The comparison between mean preoperative and postoperative scores showed an improvement in all sections of quality of life (p < 0.001). New York Heart Association functional class was significantly improved after CABG (2.23 ± 0.65 vs. 1.58 ± 0.59, p<0.001). Independent predictors of patients worsened by CABG were as follows: female gender in the pain section (p = 0.002; OR = 4.27; CI 1.74,10.47), diabetes mellitus in the physical mobility section (p = 0.003; OR = 8.09; CI 2.04,32.09), low ejection fraction in the physical mobility (p = 0.047; OR = 0.73; CI 0.56,0.95) and emotional reaction (p = 0.03; OR = 0.86; CI 0.60,0.93) sections, and postoperative complications in the social isolation (p = 0.002; OR = 4.63; CI 1.79,11.99), sleep (p = 0.03; OR = 2.71; CI 1.12,6.51), and pain (p = 0.005; OR = 3.39; CI 1.45,7.97) sections. Conclusion: The predictive factors for quality of life worsening six months after CABG are female gender, diabetes mellitus, low ejection fraction, and the presence of postoperative complications. [source] | ||||||||||