This research utilized a descriptive study to establish a relationship between educational background and accuracy of estimating blood loss. The null hypothesis, that the educational background of health care providers in the operating room has no effect on the accuracy of estimating blood loss , was tested. Ten nurse anesthesia students, 8 certified registered nurse anesthetists, 16 operating room registered nurses, 12 anesthesiologists, and 9 surgeons were included in the sample population. A number of different protocols were utilized to assess the relative accuracy of blood volumes estimates. The study was separated into four stations. Station 1 consisted of three tables, each with different sizes and types of sponges with varying amounts of blood placed on them. Four estimates were required at each table, for a total of 12 estimates. Stations 2-3-4 contained different aggregates of blood-soaked materials, requiring a single estimate at each station. Repeated measures analysis of variance (ANOVA) revealed that the means across all groups in Station 1 reached statistical significance beyond p = .05 (< .001), and the hypothesis is rejected for equal group means. However, the results for Stations 2-3-4 for equal group means did not reach statistical significance ( p = .136), therefore, do not reject the null hypothesis of equal group means.

The purpose of this study was to ascertain the effects of Healing Touch (HT) on well-being and neuroendocrine function in individuals living with HIV disease. A total of 27 males completed the 4-week HT intervention. Each weekly HT session lasted 30 minutes and consisted of only the chakra connection, Because of the small sample size and the impact of gender on neuroendocrine and immune function, women were not included in this study Dependent variables included well-being as measured by three well-being and two psychological distress instruments, serum serotonin, salivary DHEA and cortisol, and a variety of enumerative and functional measures of immune function. A pretest-posttest design experimental design including a wait-list control group was used. Multivariate analysis of covariance was used to test the research hypotheses followed by univariate analysis of variance to detect the contribution of individual variables to the overall multivariate models. It was hypothesized that HT would increase participant well-being, serum serotonin and salivary DHEA; decrease salivary cortisol; and improve immune function in individuals living with HIV disease, All of the research hypotheses were rejected. Discussion of the results as well as directions for future research are presented.

The research question for this descriptive investigation was: Does a difference exist between the maternal feeding choice and the perceived locus of control? The investigation was conducted from September 15, 1982 until October 29, 1982 in a privately owned community hospital in Southeastern United States. Two randomly selected days per week were used for data collection. The sample consisted of fifty Caucasian women between the ages of eighteen and thirty-four who had delivered a normal, viable, and stable infant within the past twenty-four to seventy-two hours. The sample consisted of twenty-six breast feeding and twenty-four formula feeding women. The subjects completed the Levenson Multifocal I/E Scale (1972) and the Demographic Tally Tool (1982), developed by the investigator. The Levenson Multifocal I/E Scale was used to ascertain the perceived degree of internalization and control by powerful others, chance and fate. The Levenson Multifocal I/E Scale consisted of twenty-four “I” statements in the Likert format. Additionally, the subjects verbally completed the Demographic Tally Tool to compile demographic data about the subjects. The Demographic Tally Tool consisted of eleven factual questions. An inferential statistical computation, the Independent t-Test, was utilized to compare the differences between the means of the two groups. Additionally, descriptive statistics such as the mean and the mode, were employed to compare the demographic data between the two groups. The analysis of the inferential statistics revealed a difference in the two groups. The formula feeding group perceived significantly (p = .05) a higher degree of control by powerful others, chance and fate than did the breast feeding group. The differences between the two groups’ means on internalization proved not to be statistically significant.

This study was conducted to evaluate a Coronary Educational Program at a 350 bed community suburban hospital. The five year old program has never been evaluated. The evaluation was limited to one product of the program, the change in patient knowledge relative to their disease. Subjects also completed a subjective evaluation of the program, including the content areas, teaching methods, and competence of the instructors. Twelve subjects participated during the 2% month study. They consisted of 10 males and 2 females; 11 Whites and 1 Black. The age range was 53 to 76 years, with a mean of 63.9 years. The educational level ranged from 4 to 17 years, with a mean of 12 years. Nine subjects were married, 2 divorced, and l widowed. Eight were Protestant, 2 Catholic, and 2 Jewish. A pre-experimental, one-group, pretest-posttest design was used. Subjects were pretested before beginning the Coronary Education Program, using the Knowledge Test, and posttested after completing the program, using the same Knowledge Test. The hypothesis stated that the subjects would have a significant increase in knowledge relative to their disease after participating in the Coronary Education Program. Subjects had a 2.2 point (2%) increase in knowledge relative to their disease. A paired t-test was used to determine the significance of the change. The resulting t-value of 1.79 was not significant at the .05 level. The hypothesis was not supported. The subjective evaluation completed at the conclusion of the program by the subjects reflected support and enthusiasm. The content areas were considered relevant to what needed to be known by myocardial infarction patients. The teaching methods, using audio-visuals, group discussion, and printed materials, were considered good. The competence of the instructors was thought to be very good.

This study, using a quasi-experimental design, was conducted to explore the effect of a cardiovascular risk factor education program on the health behaviors of a group of fifth grade children. The following hypothesis was tested: There will be a statistically significant improvement in self-reported health behaviors of school age children who receive a cardiovascular risk factor education program as compared to the self-reported health behaviors of those school age children who do not receive a cardiovascular risk factor education program. One hundred and nineteen subjects, 63 in the experimental group and 56 in the control group, were tested using the researcher's designed health behavior questionnaire, "My Health Behaviors", before and after participation in the health education program. The program provided for the experimental group consisted of eight 45 minute sessions. The introductory and summary sessions were primarily concerned with administration of the pretest and post-test and sessions two through seven were informative sessions about high fat, high cholesterol diet, smoking and sedentary lifestyle. The program provided for the control group consisted of four 45 minute sessions; session one was concerned with introductory material and administration of the pre-test, sessions two and three were informative sessions related to general nutrition and foods high in salt and sugar, and session four was devoted to review of content as well as administration of the post—test. Data were statistically analyzed using the paired-sample student's t-test. Results of the analysis revealed a significant difference between the two sample groups at p<0.01 level. The hypothesis was accepted.

In spite of continuing advances in diagnostic methods, surgical and medical management, and psychological care, cancer remains the second leading cause of death among adults in the United States (American Cancer Society, 1980), and it continues to engender feelings of futility in its victims and the general population as well. Between 1970 and 1980 more than 6.5 million new cases of cancer were diagnosed, and more than 10 million people were under medical treatment for the disease. There are over 3 million Americans presently alive who have a history of cancer (American Cancer Society, 1980). Approximately 15 percent of all malignancies occur in the colon and rectum (American Cancer Society, 1980). The American Cancer Society estimated that 120,000 new cases of colon and rectal cancer will develop in 1981, with approximately two-thirds occurring in the colon and one-third occurring in the rectum (American Cancer Society, 1980). In Virginia alone, 2,200 new cases of colo-rectal cancer are anticipated (American Cancer Society, 1980). Surgery offers the best chance of cure for individuals with malignancies confined to the colon or rectum. For those with extensive disease, it offers palliation. However, surgery for colon or rectal cancer is always radical and often mutilating. When colostomy is necessary, as it is in some 50,000 cases annually (Rowbotham, 1971), the individual is faced with drastic alterations in his body's form and function. Nursing is concerned with helping individuals cope with the effects of this illness and its treatment.

The study was conducted to determine the relationship between social support and the blood pressure of mild and moderate hypertensives. Motivation for the study was derived from the growing realization that the social support of an individual has a far-reaching effect on illness and health and that little research has been done concerning the specific effect that social support has on blood pressure. The Norbeck Social Support Questionnaire (NSSQ) was administered to a convenience sample of 30 subjects selected from among the hypertensive clients of the Family Practice Clinic and General Medical Clinic located in the Peninsula Health Center. The NSSQ gathered information about the subjects' social networks and allowed the researcher to examine the function of the social network by examining the components of the Net Social Network score. The Net Social Network score is composed of the Number in the Network, Total Function, Frequency, Duration, and Total Loss. The component scores were correlated with the observed systolic and diastolic blood pressures by using Pearson's Product Moment Correlation Coefficient as a measurement of the relationship between social support and the blood pressures of mild and moderate hypertensives. A significant correlation was found between the observed systolic blood pressure, observed diastolic blood pressure, and the variables contributing to the Net Social Support score. The hypothesis that social support affects the blood pressures of mild and moderate hypertensives was supported by the data from the sample of 30 mild and moderate hypertensives used in the study.

Pain is a universal experience. Caring for people in pain is a central aspect of nursing practice. Many studies have been done to determine the physical and psychosocial mechanisms of the pain sensation, in addition to methods of relief. Very little has been done, however, dealing specifically with the pain experienced by the burned patient. People hospitalized with thermal injuries complain most often of the intensity and long duration of their pain experience. Due to the large number of persons sustaining thermal injuries every year, it is apparent that nurses must familiarize themselves with methods of evaluation and intervention to reduce or eliminate pain. More importantly, they must be aware of how they are perceiving the burned patient's pain at any given time, and whether this is congruent with the patient's perception of his or her pain.

Graduate nurses' transition from school to the work place is challenging and often leads to burnout. There was no graduate nurse residency program in women's services at the practicum facility. As a result, this facility had been unable to recruit or hire graduate nurses in the women's services unit. The purpose of this project was to develop a nurse residency program in women's services to address the lack of formal orientation for new graduate nurses at this facility. A graduate nurse residency program will provide further training for nurses to care for a more complicated population of pregnant women. Theoretical support for this project was Duchscher's, theory of transition, which suggests that allowing graduates time to adjust within a context of support allows them to develop their thinking and practice and helps them move through the stages of professional role transition. The project included a review of literature, development of a nurse residency plan, all materials needed to operationalize the program in the institution, and plans for implementing and evaluating the program over time within the context of institutional challenges, goals, and strengths. Collaboration with institutional stakeholders helped to ensure the contextual relevance of the program and ongoing administrative ownership to provide momentum for the program to move forward following delivery of the products of the DNP project to the institution. In sum, the products of this project comprise a turn-key solution to the institutional need for a graduate nurse residency program in women's services. Social change implications include possible improvement in the recruitment and retention of graduate nurses as well as the consistent development of competent and safe practitioners who will improve maternal and newborn outcomes at the facility.

The practice problem for this quality improvement project was the lack of engagement of chronic back pain patients at a Midwest clinic in evidence-based risk/benefit discussions regarding treatment options. The project was designed to explore whether practice guidelines increase patient engagement as measured by the Patient Activation Measure (PAM). Practice guidelines for interactive patient/nurse practitioner discussions regarding treatment options were developed, implemented, and evaluated. The concepts of chronic pain, chronic pain treatment options, and patient engagement were researched, and the evidence was evaluated using the Grades of Recommendation Assessment, Development, and Evaluation system. The clinical practice guideline was developed following the domains of Agree II. The project was based on the Chronic Care Model and Roy's Adaptation Model. Sources of evidence included literature on the PAM survey and development and implementation of a clinical guideline. To evaluate the project, PAM data were analyzed using a paired t test to compare means before and after implementation of the practice guidelines. The PAM mean score was 45.86 prior to guideline implementation and 76.62 post implementation. Paired t testing (p < .000) showed statistically significant increase in scores. Implications for the patient might be a decreased level of chronic back pain by patients' full engagement in treatment options. Contributions to positive social change include increased patient engagement because patients will experience control over treatment options and experience less pain as a result.