Susan Jane Fetzer

ASPAN's Evidence-Based Clinical Practice Guideline for the Promotion of Perioperative Normothermia

Practice Guideline for the Promotion of Perioperative Normothermia Vallire D. Hooper, PhD, RN, CPAN, FAAN, Robin Chard, PhD, RN, CNOR, Theresa Clifford, MSN, RN, CPAN, Susan Fetzer, PhD, RN, Susan Fossum, BSN, RN, CPAN, Barbara Godden, MHS, RN, CPAN, CAPA, Elizabeth A. Martinez, MD, MHS, Kim A. Noble, PhD, RN, CPAN, Denise O’Brien, MSN, RN, ACNS-BC, CPAN, CAPA, FAAN, Jan Odom-Forren, PhD, RN, CPAN, FAAN, Corey Peterson, MSN, CRNA, Jacqueline Ross, MSN, RN, CPAN

ASPAN’s Evidence-Based Clinical Practice Guideline for the Promotion of Perioperative Normothermia: Second Edition

Guideline for the Promotion of Perioperative Normothermia: Second Edition Vallire D. Hooper, PhD, RN, CPAN, FAAN, Robin Chard, PhD, RN, CNOR, Theresa Clifford, MSN, RN, CPAN, Susan Fetzer, PhD, RN, Susan Fossum, BSN, RN, CPAN, Barbara Godden, MHS, RN, CPAN, CAPA, Elizabeth A. Martinez, MD, MHS, Kim A. Noble, PhD, RN, CPAN, Denise O’Brien, MSN, RN, ACNS-BC, CPAN, CAPA, FAAN, Jan Odom-Forren, PhD, RN, CPAN, FAAN, Corey Peterson, MSN, CRNA, Jacqueline Ross, MSN, RN, CPAN, Linda Wilson, PhD, RN, CPAN, CAPA, BC

A randomised controlled trial of the effect of music therapy and verbal relaxation on chemotherapy-induced anxiety

AIMS To determine the effect of music therapy and verbal relaxation on state anxiety and anxiety-induced physiological manifestations among patients with cancer before and after chemotherapy. BACKGROUND Cancer and its treatment provoke a series of changes in the emotional sphere of the patients anxiety. Music therapy and verbal relaxation had reported the anxiety reduction effect on patients with cancer receiving chemotherapy. Few studies have been undertaken comparing music therapy and verbal relaxation in differentiating high-normal state anxiety subsample. DESIGN A randomised controlled trial and permuted block design were used. Outpatient chemotherapy clinic operated by a University medical centre in southern Taiwan. METHODS Ninety-eight patients were randomised into three groups: the music therapy group received one-hour single music session; the verbal relaxation group received 30 minutes of guided relaxation; the control group received usual care. Spielberger State-Trait Anxiety Instrument, Emotional Visual Analog Scale, three biobehavioural indicators: skin temperature, heart rate and consciousness level were measured during and after chemotherapy. RESULT Music therapy had a greater positive effect on postchemotherapy anxiety than verbal relaxation and control groups and a significantly increase in skin temperature. Patients with high state anxiety receiving music therapy had a greater drop in postchemotherapy anxiety than did the normal state anxiety subsample. CONCLUSIONS Both music and verbal relaxation therapy are effective in reducing chemotherapy-induced anxiety. Thirty minutes of intervention initiates anxiety reduction. Patients with high state anxiety receiving chemotherapy obtain the most benefit from music or verbal relaxation. RELEVANCE TO CLINICAL PRACTICE Prior to chemotherapy, patients with high state anxiety must be sorted from all patients as they are more responsive to interventions. Oncology nurses can offer music and verbal relaxation as adjuvant interventions to reduce chemotherapy-induced anxiety and enhance the quality of care.

The effect of two nursing interventions on the postoperative outcomes of gynecologic laparoscopic patients

Anecdotal reports support research findings in documenting the high incidence of negative postoperative outcomes after gynecologic (GYN) laparoscopic surgery. Three outcome measures, postoperative pain, postoperative nausea and vomiting (PONV), and length of stay, have received considerable attention. Two nursing interventions frequently suggested for their positive effects are guided imagery and music therapy. An experimental pilot study was conducted to determine the effects of these nursing inventions on postoperative pain, PONV, and length of stay for GYN laparoscopic patients (n = 84). During the perioperative period, patients were randomly assigned to one of 3 interventions: guided imagery audiotapes (GI), music audiotapes (MU), or standard care (C), and outcome measures were evaluated. Results indicated that patients in both the guided imagery and music groups had significantly less pain on PACU discharge to home than the patients in the control group. These findings suggest that both guided imagery and music are effective strategies in improving pain, a difference that becomes apparent when the patient is ready to be discharged. It is possible that these interventions act as distractions in reducing the report of negative postoperative outcomes.

Intention to obtain human papillomavirus vaccination among taiwanese undergraduate women

Background: The human papillomavirus (HPV) vaccine provides an effective strategy against HPV infection, genital warts, and cervical cancer. While the HPV vaccine is available worldwide, acceptance outside of Western countries is unknown. The purpose of the study was to examine health beliefs and intention to obtain the HPV vaccination among undergraduate women in Taiwan. A predictive model of HPV vaccination intention was investigated. Methods: A convenience sample of 845 female undergraduate students (mean age = 20 years, aged: 17–36 years) recruited from 5 universities located in South Taiwan, provided data. A self-administered questionnaire requested demographic information, gynecologic history, awareness of HPV and the vaccine, health beliefs, and intention to obtain the HPV vaccine. Results: Over 50% of the undergraduate women were aware of HPV and the HPV vaccine. Sixty-three percent of the students reported a high intention to obtain the HPV vaccine. Demographic factors predicting HPV vaccination included: age, family history of gynecologic cancer, personal history of gynecological visit, sexual experience, and awareness of HPV and the HPV vaccine. Health belief factors predicting HPV vaccination included: personal susceptibility of disease, perception of disease severity, attributes of HPV, cost and availability of vaccine, attributes of HPV, and recommendations from others. Conclusions: Improving undergraduate women’s HPV vaccination rate will require educational campaigns, specifically focused on the efficacy, safety, and benefits of the HPV vaccine and the attributes of HPV infection. Targeting incoming students who are not yet sexually active could achieve successful outcomes.

Reducing venipuncture and intravenous insertion pain with eutectic mixture of local anesthetic: A meta-analysis

BackgroundThe eutectic mixture of local anesthetics (EMLA), by producing dermal anesthesia through contact with intact skin, has become a major indication for the reduction of pain experienced during venipuncture (VE) and intravenous (IV) insertion. ObjectivesThe purpose of the study was to determine the mean effect sizes and moderators of EMLA cream application in reducing VE and IV insertion pain. MethodA meta-analysis of 20 studies was conducted to determine the magnitude of the effect of EMLA cream on VE and IV insertion pain. Effect sizes were calculated three ways: weighted, unweighted, and weighted by quality index score. Potential moderating variables of sample age, premedication, therapist control, insertion site, application duration, research design, pain scale, and funding, were investigated for their influence on EMLA’s effect. ResultsEMLA cream had a large significant effect on VE pain (d = 1.05) with a 95% confidence interval from .92 to 1.34 and a large significant effect on IV insertion pain (d = 1.04) with a 95% confidence interval from .84 to 1.46. Subject age (child versus adult), type of pain scale, number of therapists, location of insertion site, premedication, funding, or study design did not appear to act as effect modifiers. ConclusionsEMLA cream can significantly decrease VE and IV insertion pain in 85% of the population.

Professionalism of Associate Degree Nurses: The Role of Self-Actualization.

Historically, nursing has affirmed the inductive approach to professionalism gained through education at the baccalaureate level. Research has challenged the inductive approach by identifying professionalism among associate degree-prepared nurses returning for the professional degree. Two variables derived from the literature, self-actualization and work experience, were investigated as possible antecedents to the development of professional attitudes, values, and behaviors of associate degree nurses. Findings indicated that self-actualization was positively and significantly related to the degree of professionalism. The need to reevaluate the induction model of professional socialization and consider a reactive approach is considered.

Health promotion lifestyle profile-II: Chinese version short form

AIM This paper is a report of an examination of the validity and reliability of the Chinese version of the Health Promoting Lifestyle Profile. BACKGROUND The Health Promotion Lifestyle Profile, a well-known instrument measuring health promotion lifestyle behaviours and developed by Walker in 1987 and later refined, has been translated into several languages. The original Chinese translated version, based on Walkers 48-item 1987 version, detected six dimensions of health promotion lifestyle behaviours. The 52-item revised Health Promotion Lifestyle Profile-II has not been tested for Mandarin-speakers. METHOD After the English version of the Health Promotion Lifestyle Profile-II was translated into Chinese using established forward-backward translation procedures, the psychometric properties of the translated version were determined with 331 Taiwanese Mandarin-speaking adults. Data were collected from August 2007 to July 2008 at outpatient clinics for health screening in Southern Taiwan. The psychometric properties of the instrument were evaluated, including the internal consistency, test-retest reliability, item analysis and factor analysis. RESULTS Neither Walkers original 6-factor model nor a forced 6-factor solution of the 52 items of the Health Promotion Lifestyle Profile-II was supported. Parallel analysis suggested that five factors be retained, with the 5-factor solution statistically and conceptually satisfactory. The 5-factor Chinese version of the Health Promoting Lifestyle Profile explained 53% of the variance in healthy lifestyles. Thirty items were retained for the Chinese version of the Health Promoting Lifestyle Profile. DISCUSSION Deletion of 22 items from the Health Promotion Lifestyle Profile-II did not impair the ability of the Chinese version of the Health Promoting Lifestyle Profile to measure a healthy lifestyle among a sample of Taiwanese adults. The data support the fact that lifestyle is influenced by culture.

Toothbrushing versus toothbrushing plus tongue cleaning in reducing halitosis and tongue coating: a systematic review and meta-analysis.

Background:Halitosis affects people of all ages. Among hospitalized patients, oral care includes toothbrushing and mouth rinses. Tongue cleaning is not included in most guidelines or nursing education curricula. Objectives:The aim of this study was to compare the effectiveness of two types of oral care, toothbrushing alone and toothbrushing plus tongue cleaning, on halitosis and tongue coating (TC). Methods:A systematic review and meta-analysis of randomized controlled trials were conducted to compare toothbrushing and toothbrushing plus tongue cleaning during oral care to reduce halitosis and TC. The databases included PubMed, ProQuest, CINAHL, the Cochrane Central Register of Controlled Trials, experts, and bibliographic review. A quality assessment of study reports and methodology was conducted using the CONSORT checklist and the Jadad Scale. The measurement of volatile sulfide compounds (VSCs) evaluated halitosis, whereas TC was measured with assessment indexes. Results:Seven experimental data sets were obtained from five randomized clinical trials. There were 188 male and 63 female subjects within an age range of 17–80 years. All intervention groups indicate a large effect size of toothbrushing plus tongue cleaning decreases volatile sulfur compounds and TC by 0.745 and 0.922, respectively, compared with toothbrushing only. Discussion:The use of toothbrushing plus tongue cleaning compared with toothbrushing alone significantly reduced the indicators of halitosis and TC. However, there is insufficient evidence to recommend frequency, duration, or delivery method of tongue cleaning. Further research is needed to articulate a comprehensive clinical guideline. Oral care is an important nursing intervention. Tongue cleaning should be incorporated into current nursing procedures.

Knowledge and beliefs about cervical cancer and human papillomavirus among Taiwanese undergraduate women.

PURPOSE/OBJECTIVES To assess knowledge and attitudes regarding cervical cancer and human papillomavirus (HPV) among undergraduate women in Taiwan. DESIGN A descriptive cross-sectional design. SETTING Five universities in southern Taiwan. SAMPLE 953 undergraduate women aged 17-36 years. METHODS The self-administered HPV Belief questionnaire was used to collect data on knowledge and beliefs regarding cervical cancer, Pap testing, and HPV. MAIN RESEARCH VARIABLES Knowledge, beliefs, cervical cancer, Pap testing, HPV, likelihood of cervical cancer, and HPV infection. FINDINGS Seventy percent of participants agreed that cervical cancer could be prevented and was a severe disease, and 80% knew the purpose of Pap testing. Forty-nine percent were aware of HPV. Undergraduate women with an awareness of HPV were more likely to be older, studying a health-related major, have a higher class standing, have a personal history of gynecologic visits, and have had a Pap test. Neither family history of gynecologic cancer nor sexual experience predicted HPV awareness, although sexual experience had a significant association with the knowledge and beliefs of cervical cancer. Most of the undergraduate women believed themselves unlikely to acquire cervical cancer or HPV infection. CONCLUSIONS Undergraduate women in Taiwan have limited knowledge of cervical cancer and HPV. Awareness of the likelihood of HPV infection is low among undergraduate women, even those who are sexually active. IMPLICATIONS FOR NURSING Educational campaigns focusing on cervical cancer screening and HPV infection are needed, particularly for sexually active undergraduate women.