RESUMEN
BACKGROUND: Problem behaviours that occur during Alzheimer's disease (AD) can have major impact on caregivers. How caregivers react to these behaviours may determine the total impact experienced from caregiving. PURPOSE: This study examined the relationships between problematic behaviours and caregiving impact in 30 primary caregivers of persons with AD. The first question explored the relationship between frequency of problem behaviour and impact; the second explored the relationship between caregiver reactions to problem behaviours and impact from caregiving. METHODS: The frequency of problem behaviour and the caregiver reaction was measured using The Revised Memory and Behaviour Problem Checklist (Teri et al. 1992). The impact from caregiving was operationalized using the Cost of Care Index developed by Kosberg and Cairl (1986). RESULTS: Significant associations were found for 11 of the 20 subscales that measured the association between the frequency of problem behaviour in the client and the impact from caregiving experienced by the caregiver. In comparison, the association between caregiver's reaction to problem behaviours and impact from caregiving was even more significant in value with 15 subscales of 20 being significant. Female caregivers experienced a greater reaction to disruptive and depressive behaviour when compared with male caregivers even though both genders reported similar frequencies of problem behaviours. In regard to findings about the impact from caregiving, four of the six indicators were higher for women than for men. CONCLUSIONS: Caregiver reaction to problem behaviours was more highly associated with impact from caregiving than the actual frequency of the behaviours. These findings have great implications for intervention programs. Caregivers, especially females, need to receive individualized, specific education/training on how to understand and manage disruptive and depressive behaviour in persons with AD.
Asunto(s)
Enfermedad de Alzheimer/psicología , Cuidadores/psicología , Trastorno Depresivo/psicología , Trastornos de la Memoria/psicología , Trastorno de la Conducta Social/psicología , Adulto , Anciano , Anciano de 80 o más Años , Costo de Enfermedad , Trastorno Depresivo/etiología , Femenino , Humanos , Masculino , Trastornos de la Memoria/etiología , Persona de Mediana Edad , Trastorno de la Conducta Social/etiología , Estrés Psicológico/etiología , Estados UnidosRESUMEN
BACKGROUND: Cardiac catheterization is a common procedure that involves the introduction of a small sheath (5F-8F) into the femoral artery for insertion of other diagnostic catheters. After cardiac catheterization, local compression of the femoral artery is required to prevent bleeding and to achieve hemostasis. Traditional methods of achieving hemostasis require significant time and close supervision by medical personnel and can contribute to patients' discomfort. VasoSeal is a recently developed device that delivers absorbable collagen into the supra-arterial space to promote hemostasis. OBJECTIVES: To compare outcomes between patients receiving a collagen plug and patients in whom a traditional method of achieving hemostasis was used after diagnostic cardiac catheterization. METHODS: An outcomes tracking tool was used to analyze the medical records of 95 patients in whom a traditional method was used (traditional group) and 81 patients in whom VasoSeal was used (device group) to achieve hemostasis. Complications at the femoral access site, patients' satisfaction, and times to hemostasis, ambulation, and discharge were compared. RESULTS: Hematomas of 6-cm diameter occurred in 5.3% of the traditional group; no complications occurred in the device group. The device group also achieved hemostasis faster and had earlier ambulation (P < .001). Patients in the device group were discharged a mean of 5 hours sooner than patients in the traditional group (P < .05). No significant differences were found in patients' satisfaction. CONCLUSIONS: VasoSeal is a safe and effective method of achieving hemostasis after cardiac catheterization that can hasten time to hemostasis, ambulation, and discharge.
Asunto(s)
Cateterismo Cardíaco , Arteria Femoral , Técnicas Hemostáticas/instrumentación , Adulto , Anciano , Anciano de 80 o más Años , Colágeno/administración & dosificación , Equipos y Suministros , Femenino , Hematoma/etiología , Técnicas Hemostáticas/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , PresiónRESUMEN
Cotton is more heavily treated with insecticides than any other crop in the United States. In southern Texas, this heavy treatment resulted in insecticide- resistant strains of major pests which almost destroyed the industry in the late 1960's and early 1970's. An integrated insect control program based on new short-season cotton varieties and traditional cultural practices has restored production in the area. The new system has been widely implemented because it produces greater net returns by reducing the use of insecticides, fertilizer, and irrigation.