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Nonpharmacologic Interventions (nonpharmacologic + intervention)
Selected AbstractsEfficacy of Aerobic Exercise on Coronary Heart Disease Risk FactorsPREVENTIVE CARDIOLOGY, Issue 2 2008George A. Kelley DA The authors examined the effects of aerobic exercise on selected coronary heart disease (CHD) risk factors using data from previously published meta-analyses. Using a random effects model, the effects of aerobic exercise on glycosylated hemoglobin (HbA1c) (mean, 95% confidence interval, ,0.9%, ,1.9% to 0.03%), resting systolic blood pressure (,6.9 mm Hg, ,9.1 to ,4.6 mm Hg), low-density lipoprotein cholesterol (,3.1 mg/dL, ,6.1 to 0 mg/dL), and body mass index (,1.3 kg/m2, ,2.5 to ,0.1 kg/m2) were either statistically significant or demonstrated a trend for statistical significance. Changes were equivalent to relative reductions of ,8.5%, ,4.7%, ,2.0%, and ,4.5%, respectively. Changes corresponded to estimated 5-year reductions in CHD mortality of 14%, 17%, 1.5%, and 5%, respectively. The results of this review reinforce the idea that aerobic exercise is an important nonpharmacologic intervention for improving selected CHD risk factors. [source] Provision of social support to individuals with chronic fatigue syndrome,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 3 2010Leonard A. Jason The present study evaluated a buddy program designed to provide support for individuals with chronic fatigue syndrome (CFS). The intervention involved weekly visits by a student paraprofessional, who helped out with tasks that needed to be done in an effort to reduce some of the taxing demands and responsibilities that participants regularly encountered. This model of rehabilitation focused on avoiding overexertion in persons with CFS, aiming to avoid setbacks and relapses while increasing their tolerance for activity. Participants with CFS were randomly assigned to either a 4-month buddy intervention or a control condition. Posttest results showed that individuals who received a student buddy intervention had significantly greater reductions in fatigue severity and increases in vitality than individuals in the control condition. There were no significant changes between groups for physical functioning and stress. Buddy interventions that help patients with CFS reduce overexertion and possibly remain within their energy envelopes can be thought of as representing a different paradigm than nonpharmacologic interventions that focus only on increasing levels of activity through graded exercise. © 2009 Wiley Periodicals, Inc. J Clin Psychol 66: 249,258, 2010. [source] Recognition, diagnosis, and treatment of restless legs syndromeJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 8 2008ARNP (Adult Nurse Practitioner, Jennifer E. Smith MSN, Manager of an Anticoagulation Clinic) Abstract Purpose: To review the symptoms, diagnosis, and treatment of restless legs syndrome (RLS) and its relevance to nurse practitioners (NPs). Data sources: Comprehensive review of the scientific literature on the diagnosis and treatment of RLS in adults. Conclusions: RLS is a chronic neurological disorder that, with varying degrees of severity, affects 5%,10% of the general population. Because of the circadian pattern of onset, the symptoms of RLS may be associated with significant sleep disturbance and may have a negative impact on quality of life. RLS is characterized by a compelling urge to move the legs and usually accompanied or caused by uncomfortable sensations in the legs. Symptoms begin or worsen during periods of rest or inactivity and are worse in the evening or at night. Other features supportive of a diagnosis include a family history, the presence of periodic leg movements in sleep, and the relief of symptoms after treatment with a dopaminergic therapy. Although the etiology of RLS is unknown, it is thought that symptoms result from a central dopaminergic dysfunction and dopamine agonists are considered first-line treatment for moderate-to-severe primary RLS. Nondopaminergic therapies and nonpharmacologic interventions may also be appropriate in the management of less severe cases of RLS. Implications for practice: NPs are often the first healthcare providers to see patients with RLS and therefore need to be able to accurately recognize and diagnose the disorder; this, in turn, will enable them to successfully manage the treatment of RLS. [source] Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS), a Focus Group and Decision Support Tool Development ProjectACADEMIC EMERGENCY MEDICINE, Issue 8 2010Paula Tanabe PhD ACADEMIC EMERGENCY MEDICINE 2010; 17:848,858 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, A decision support tool may guide emergency clinicians in recognizing assessment, analgesic and overall management, and health service delivery needs for patients with sickle cell disease (SCD) in the emergency department (ED). We aimed to identify data and process elements important in making decisions regarding evaluation and management of adult patients in the ED with painful episodes of SCD. Methods:, Qualitative methods using a series of focus groups and grounded theory were used. Eligible participants included adult clients with SCD and emergency physicians and nurses with a minimum of 1 year of experience providing care to patients with SCD in the ED. Patients were recruited in conjunction with annual SCD meetings, and providers included clinicians who were and were not affiliated with sickle cell centers. Groups were conducted until saturation was reached and included a total of two patient groups, three physician groups, and two nurse groups. Focus groups were held in New York, Durham, Chicago, New Orleans, and Denver. Clinician participants were asked the following three questions to guide the discussion: 1) what information would be important to know about patients with SCD in the ED setting to effectively care for them and help you identify patient analgesic, treatment, and referral needs? 2) What treatment decisions would you make with this information? and 3) What characteristics would a decision support tool need to have to make it meaningful and useful? Client participants were asked the same questions with rewording to reflect what they believed providers should know to provide the best care and what they should do with the information. All focus groups were audiotaped and transcribed. The constant comparative method was used to analyze the data. Two coders independently coded participant responses and identified focal themes based on the key questions. An investigator and assistant independently reviewed the transcripts and met until the final coding structure was determined. Results:, Forty-seven individuals participated (14 persons with SCD, 16 physicians, and 17 nurses) in a total of seven different groups. Two major themes emerged: acute management and health care utilization. Major subthemes included the following: physiologic findings, diagnostics, assessment and treatment of acute painful episodes, and disposition. The most common minor subthemes that emerged included past medical history, presence of a medical home (physician or clinic), individualized analgesic treatment plan for treatment of painful episodes, history of present illness, medical home follow-up available, patient-reported analgesic treatment that works, and availability of analgesic prescription at discharge. Additional important elements in treatment of acute pain episodes included the use of a standard analgesic protocol, need for fluids and nonpharmacologic interventions, and the assessment of typicality of pain presentation. The patients' interpretation of the need for hospital admission also ranked high. Conclusions:, Participants identified several areas that are important in the assessment, management, and disposition decisions that may help guide best practices for SCD patients in the ED setting. [source] | ||||||||||