Anne Keane

Risk Factors for Chronic Posttraumatic Stress Symptoms and Behavior Problems in Children and Adolescents Following a Home Fire

Based on a model of (Posttraumatic Stress Disorder) PTSD by Green, Wilson and Lindy (1986), fifty-six children ages 6 to 17 years were interviewed at five months (T1) and 9 months (T2) after a fire in their homes. Outcome variables were PTSD and behavior problems. Major correlates of the outcome variables, include guilt at T1, worry about other family members at T2, and lack of satisfaction with family support at both times, as well as the attribution that “another child did it.” The stressor variable, “present at the fire,” became significant only at T2. The greatest variance in the PTSD scores occurred at T2 suggesting delayed onset or delayed reporting by children. Children may process traumatic events in a different cognitive fashion and in a different time frame than adults. Implications of these results are considered within the context of social work and nursing.

Psychological distress in survivors of residential fires

This paper presents preliminary findings from an ongoing study of survivors of residential fires. The purpose of this study was to examine psychological distress and extent of loss in order to provide a psychological profile of survivors overtime. The sample (N = 69) was drawn consecutively from the database of residential fires available through the Philadelphia Fire Department. Levels of psychological distress were measured as well as reports of symptoms consistent with the diagnostic criteria for Post-traumatic Stress Disorder. The major findings indicate that residential fires caused significant and sustained distress. An agenda for further research and for services to survivors of these fires is presented.

The Nurse Practitioner in Tertiary Care

Todays healthcare environment is typified by patients with specialized healthcare needs who are hospitalized for acute illness, but discharged quickly with continued needs. Dramatic changes in healthcare coupled with increasingly complex patients have challenged leaders in tertiary care settings. The nurse practitioner (NP) role, although initially conceptualized as a response to primary care needs, can and should be expanded to the care of patients with specialized healthcare needs in tertiary care. There is precedent for the NP role in tertiary care. For example, the neonatal NP whose primary base of practice is the neonatal intensive care unit. The decision to extend the NP role into tertiary care and the responsibility to implement the role rests with the nurse executive. We spoke with seven nurse executives in tertiary care hospitals to explore their ideas concerning why the role is needed and to discuss issues critical to successful implementation of the NP role.

Relationship of Locus of Control to Preoperative Anxiety

Scores on Rotters I-E scale and Zuckermans Multiple Affect Adjective Check List, Today Form for 91 presurgical patients (18–85 yr.) were symmetrically distributed. When I-E scores were partitioned Externals were significantly more anxious than Internals, but the actual mean difference was small. About 10% of the variance in anxiety was accounted for by the r of .31 with I-E scores. Time of day of test was not critical.

A typology of residential fire survivors' multidimensional needs.

This article presents an analysis of the tangible, psychological, and general needs of adults and their children reported by residential fire survivors approximately 14 weeks postfire. Three hundred and seven survivors, who identified that they needed help for themselves or their children, differed from 133 survivors who did not request help. Those needing help were more likely to be women with children younger than age 18 living in their household, have low-income status, less education, and to have already received services from church groups. The classification of self-identified needs of fire survivors included the need for specific tangible and social service assistance, psychological and spiritual support, and nonspecific assistance. This classification contributes to our understanding of the relationship between needs and loss, grief, and changes in family and life situations postfire.

Quality assurance: evaluate thyself.

Quality assurance (qa) programs must be documented carefully, systematically, and completely to be of continued value. A literature review revealed that no tools had been developed to evaluate the effectiveness of qa programs. A tool was designed and tested to assess the reports of qa studies, as an initial step in establishing the benefits of qa. The tool was found to yield reproducible results and its use is recommended to others.