Journal of the American Academy of Nurse Practitioners最新文献

{"title":"Health promotion/risk reduction and disease prevention in women's health.","authors":"Judith A Berg, Diane Todd Pace","doi":"10.1111/j.1745-7599.2009.00480.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2009.00480.x","url":null,"abstract":"This special issue is focused on health promotion, risk reduction, and disease prevention in women’s health. Women’s health care is an important focal area for nurse practitioners (NPs) and is specified as one of the population specialties for NP preparation. As well, the majority of patient care visits to NPs who specialize in adult, family, and gerontology practice are from women. Therefore, it is particularly apt for the Journal of the American Academy of Nurse Practitioners to offer this special issue highlighting research, literature reviews, and clinical papers that focus on aspects of health promotion, risk reduction, and disease prevention for women. Several national initiatives prioritize health promotion and disease prevention. National objectives detailed in Healthy People 2010 recognize that preventing illness, disability, and premature death by encouraging patients to pursue healthy lifestyle goals is in large part dependent upon the health promotion message conveyed by healthcare providers (Healthy People 2010, 2000). The Pew Commission’s final report recommended 21 competencies for the health professions (University of California San Francisco [UCSF], 1998). Competency number 7 challenged healthcare providers to rigorously practice preventive health care. For NPs, this mandate aligns with our overall philosophy of care and reflects our basic nursing backgrounds. NPs have always excelled at preventive health care that embraces health promotion, risk reduction, and disease prevention. In fact, the domains and core competencies of NP practice published by the National Organization of Nurse Practitioner Faculties (NONPF) in 1990 (updated in 1995 and 2000) specify five core competencies related to health promotion/health protection and disease prevention in the first domain, management of patient health/illness status (National Organization of Nurse Practitioner Faculties [NONPF], 1990, 1995, 2000). Further, primary care competencies in the specialty areas of adult, family, gerontology, pediatrics, and women’s health all have health promotion, health protection, disease prevention, and treatment as the first domain of practice (NONPF, 2002). Together these documents provide the parameters for NP primary care entry-level practice to be mastered by all. Several surveys of NP practice have been conducted that validate how NPs equate to their preventive health mandate. In a 2008 descriptive survey of NP practice, 24.8% of visits over a 6-month period were for nonillness and health promotion visits. In addition, of all primary care visits, NPs provided counseling in 84% of them (compared with physician colleagues at 61%) as therapeutic and preventive services, such as nutrition counseling, physical exercise, family planning, prenatal instructions, tobacco use, and growth and development (Deshefy-Longhi, Swartz, & Grey, 2008). An earlier study of Texas NPs’ (n = 442) health promotion attitudes and practices found that they had positive attitu","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"22 2","pages":"57-9"},"PeriodicalIF":0.0,"publicationDate":"2010-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2009.00480.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28693553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary heart disease knowledge tool for women.","authors":"Joanne L Thanavaro,&nbsp;Samer Thanavaro,&nbsp;Timothy Delicath","doi":"10.1111/j.1745-7599.2009.00476.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2009.00476.x","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a tool that measures coronary heart disease (CHD) knowledge specifically for women.</p><p><strong>Data sources: </strong>The new CHD knowledge tool, based on previous surveys of women's CHD knowledge, has 25 multiple-choice questions. An expert panel evaluated content and face validity. The tool was pilot tested in women without CHD, who were admitted to a Chest Pain Center. The tool was subsequently administered to laywomen and female cardiovascular nurses to evaluate its validity and reliability. The sample included 49 women as the control group (Group 1), 23 cardiovascular nurses as a known group (Group 2), and 22 women with an educational program as the treatment group (Group 3). Knowledge of women in Group 1 was compared with Groups 2 and 3 in known group and predictive validity tests.</p><p><strong>Conclusion: </strong>The new tool demonstrates good validity and reliability to measure CHD knowledge in women.</p><p><strong>Implications for practice: </strong>Women continue to have low CHD knowledge, and nurse practitioners should provide education to improve women's CHD knowledge as a strategy to promote healthy lifestyle practices and CHD risk prevention. The new tool can be utilized in future research to measure women's CHD knowledge.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"22 2","pages":"62-9"},"PeriodicalIF":0.0,"publicationDate":"2010-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2009.00476.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28693554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations for the use of progestin-only contraceptives.","authors":"Sarah Freeman,&nbsp;Lee P Shulman","doi":"10.1111/j.1745-7599.2009.00473.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2009.00473.x","url":null,"abstract":"<p><strong>Purpose: </strong>To highlight the characteristics of progestin-only contraceptives (POCs) currently available in the United States, and to explore the potential of these agents as first-line contraceptive options for women seeking health promotion by prevention of an unwanted pregnancy. The progestin-only pills (Micronor and Ovrette), depot medroxyprogesterone acetate (DMPA) injections (Depo-Provera and depo-subQ provera 104), levonorgestrel intrauterine system (IUS) (Mirena), and etonogestrel implant (Implanon) will be reviewed. The use of levonorgestrel (Plan B) as an emergency contraceptive will also be considered briefly.</p><p><strong>Data sources: </strong>Worldwide medical literature and the prescribing information for the specified products.</p><p><strong>Conclusions: </strong>A number of POCs are currently available for routine birth control in the United States, ranging from the daily progestin-only pill to nondaily contraceptive options such as injectable DMPA, the levonorgestrel-releasing IUS, and the etonogestrel-releasing contraceptive implant. Each of these methods has specific advantages, but also specific drawbacks that can result in discontinuation of treatment if users are not given adequate information about what to expect in terms of side effects. It is critical that clinicians provide adequate and accurate information along with detailed counseling to women who are considering using POCs, as well as providing periodic reinforcement of the information at regular clinic visits for those already using POCs.</p><p><strong>Implications for practice: </strong>Given that a large number of pregnancies are unplanned and create a significant impact on social, economic, and health outcomes, it is important for the clinician to have a vast knowledge of contraceptive options. POCs offer significant choices in contraception. By proactively addressing common concerns (such as potential effects on weight, mood, menstrual bleeding patterns, and bone mineral density), clinicians may improve the likelihood of adherence and continuation with POCs for routine birth control.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"22 2","pages":"81-91"},"PeriodicalIF":0.0,"publicationDate":"2010-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2009.00473.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28693556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of endometriosis: the role of the advanced practice nurse in primary care.","authors":"Alexandra J Mao,&nbsp;Joyce K Anastasi","doi":"10.1111/j.1745-7599.2009.00475.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2009.00475.x","url":null,"abstract":"Purpose: To discuss the etiology, clinical presentation, diagnosis, and management of endometriosis for the advanced practice nurse (APN) in primary care. Data sources: Selected research, clinical studies, clinical practice guidelines, and review articles. Conclusions: Commonly encountered by the APN in primary care, endometriosis is a chronic, progressive inflammatory disease characterized by endometrial lesions, cysts, fibrosis, or adhesions in the pelvic cavity, causing chronic pelvic pain and infertility in women of reproductive age. Because of its frequently normal physical examination findings, variable clinical presentations, and nonspecific, overlapping symptoms with other conditions, endometriosis can be difficult to diagnose. As there currently are no accurate noninvasive diagnostic tests specific for endometriosis, it is imperative for the APN to become knowledgeable about the etiology, clinical presentation, diagnosis, and current treatment options of this disease. Implications for practice: The APN in primary care plays an essential role in health promotion through disease management and infertility prevention by providing support and much needed information to the patient with endometriosis. APNs can also facilitate quality of care and manage treatments effectively to improve quality of life, reduce pain, and prevent further progression of disease. Practice recommendations include timely diagnosis, pain management, infertility counseling, patient education, and support for quality of life issues.","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"22 2","pages":"109-16"},"PeriodicalIF":0.0,"publicationDate":"2010-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2009.00475.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28693559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of African-American women's frustrations with chronic recurrent bacterial vaginosis.","authors":"Sandra C Payne,&nbsp;Pamela R Cromer,&nbsp;Michele K Stanek,&nbsp;Allyson A Palmer","doi":"10.1111/j.1745-7599.2009.00474.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2009.00474.x","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to explore the impact of recurrent bacterial vaginosis (BV) and its treatment on quality of life (QOL), acceptance of current treatment options, and psychosocial issues related to lifestyle practices associated with BV.</p><p><strong>Data sources: </strong>Qualitative and quantitative data were obtained from 23 African American women with recurrent BV. Participants completed a short survey, developed by the researchers based on a prior study which examined factors associated with recurrent BV, and a one-on-one interview assessing the impact of BV, current treatment modalities, and lifestyle practices related to recurrent BV.</p><p><strong>Conclusions: </strong>Emerging themes suggest that recurrent BV is associated with psychosocial issues that are currently not addressed in a typical office visit. Reported feelings of shame and embarrassment often cause women to engage in hypervigilant routines of hygiene that negatively impact their professional, personal, and intimate relationships, significantly affecting their QOL.</p><p><strong>Implications for practice: </strong>Without proper education, advice, and support, BV is perpetuated by lifestyle practices leading to recurrent infection and associated symptoms. With proper guidance, it is expected that women with recurrent BV will see an improvement in their QOL, with fewer complications from BV infection, and healthy relationships with intimate partners, family, and friends.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"22 2","pages":"101-8"},"PeriodicalIF":0.0,"publicationDate":"2010-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2009.00474.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28693558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"If pelvic inflammatory disease is suspected empiric treatment should be initiated.","authors":"Lisa Abatangelo,&nbsp;Lilian Okereke,&nbsp;Cheryle Parham-Foster,&nbsp;Colleen Parrish,&nbsp;Leanne Scaglione,&nbsp;Deborah Zotte,&nbsp;Leslie-Faith Morritt Taub","doi":"10.1111/j.1745-7599.2009.00478.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2009.00478.x","url":null,"abstract":"<p><strong>Purpose: </strong>To assist the nurse practitioner (NP) to make a rapid diagnosis and develop a treatment plan for pelvic inflammatory disease (PID) in order to assist women to promote their health and reduce their risk of the unnecessary sequelae of infertility, tubal damage, and the possibility of a subsequent ectopic pregnancy.</p><p><strong>Data sources: </strong>Centers for Disease Control guidelines and recent clinical practice literature were searched to provide guidance on how to diagnose, treat, and educate the patient with PID.</p><p><strong>Conclusions: </strong>The incidence of PID is approximately 1 million women annually. PID is diagnosed in 1%-2% of sexually active women under the age of 25, with a higher incidence in African American women. Women with PID produce over 2 million emergency room and office visits and incur health care costs of over 4 billion dollars annually.</p><p><strong>Implications for practice: </strong>PID is associated with chronic pelvic pain, infertility, and ectopic pregnancy. Symptoms can range from subtle and indolent to acute and fulminant. Having a high index of suspicion for the diagnosis will assist the NP in treating patients with this disease. Empiric antibiotic therapy should be initiated in all women at risk who have uterine, adnexal, or cervical motion tenderness on a bimanual exam with no other explanation for these symptoms. Without response to treatment, if the diagnosis is unclear, or if a surgical emergency is being considered, prompt referral to a specialist is warranted. Secondary preventive measures are discussed.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"22 2","pages":"117-22"},"PeriodicalIF":0.0,"publicationDate":"2010-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2009.00478.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28693560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of cancer pain guidelines by acute care nurse practitioners using an audit and feedback strategy.","authors":"Dorothy Dulko,&nbsp;Elisheva Hertz,&nbsp;Jerelyn Julien,&nbsp;Susan Beck,&nbsp;Kathi Mooney","doi":"10.1111/j.1745-7599.2009.00469.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2009.00469.x","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the availability of clinical practice guidelines (CPGs) for cancer pain, consistent integration of these principles into practice has not been achieved. The optimal method for implementing CPGs and the impact of guidelines on healthcare outcomes remain uncertain. This study evaluated the effect of an audit and feedback (A/F) intervention on nurse practitioner (NP) implementation of cancer pain CPGs and on hospitalized patients' self-report of pain and satisfaction with pain relief.</p><p><strong>Data sources: </strong>Eight NPs and two groups of 96 patients were the sources of data. Eligible patients in both groups completed the Brief Pain Inventory-Short Form (BPI-SF) within 24 h of admission and every 48 h until discharge. During A/F, NPs received weekly feedback on pain scores and guideline adherence.</p><p><strong>Conclusions: </strong>Nurse practitioner adherence to CPGs increased during A/F. Pain intensity did not significantly differ between groups. Intervention group patients reported significantly less overall pain interference (p < .0001), interference with general activity (p = .0003), and sleep (p = .006). Satisfaction with pain relief increased from 68.4% to 95.1% during A/F (p < .0001).</p><p><strong>Implications for practice: </strong>A/F is an effective strategy to promote CPG use. Improved functional status in the absence of decreased pain severity underscores the need to consider symptom clusters when studying pain.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"22 1","pages":"45-55"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2009.00469.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28646925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life of adult patients with sickle cell disease.","authors":"Valerie Mann-Jiles,&nbsp;Diana Lynn Morris","doi":"10.1111/j.1745-7599.2009.00416.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2009.00416.x","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this descriptive study was to examine quality of life (QOL) in adult patients with sickle cell anemia, hemoglobin SC, or hemoglobin S beta thalassemia.</p><p><strong>Data sources: </strong>Data were collected from a convenience sample of 62 adult patients (18 years of age and older) with sickle cell disease (SCD) in an outpatient clinic devoted to the care of hematological and oncological disorders. Burckhardt and Anderson's 16-item self-report Quality of Life Scale (QOLS) and a demographic questionnaire were used for data collection.</p><p><strong>Conclusions: </strong>The average QOLS scores for healthy populations are 90. The overall mean QOL score in this study of 83.6 (SD = 13.2) was lower than those of the general population. In this study, scores ranged from 52 to 112. Approximately 35% (n = 22) of participants' scores ranged from 52 to 75; approximately 35% (n = 22) of participants' scores ranged from 75 to 85; and approximately 30% (n = 17) of participants' scores ranged from 85 to 112. Other results were nonsignificant for all variables except the variable that assessed the extent to which participants consider themselves to be spiritual. Future research is needed to further the understanding of the impact of QOL in adults with SCD.</p><p><strong>Implications for practice: </strong>A better understanding of adult patients with SCD QOL may ultimately improve healthcare services for this population. The findings could lead to future research that can identify factors that most impact the QOL of people living with SCD.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"21 6","pages":"340-9"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2009.00416.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28320378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory processing disorder: any of a nurse practitioner's business?","authors":"Mary W Byrne","doi":"10.1111/j.1745-7599.2009.00417.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2009.00417.x","url":null,"abstract":"<p><strong>Purpose: </strong>Children who exhibit the confusing symptom patterns associated with sensory processing deficits are often seen first by primary care providers, including family and pediatric nurse practitioners (NPs). The purpose of this article is to alert NPs to the state of the science for these disorders and to the roles NPs could play in filling the knowledge gaps in assessment, treatment, education, and research.</p><p><strong>Data sources: </strong>Literature searches using PubMed and MedLine databases and clinical practice observations.</p><p><strong>Conclusions: </strong>Sensory integration disorders have only begun to be defined during the past 35 years. They are not currently included in the DSM IV standard terminology, and are not yet substantively incorporated into most health disciplines' curricula or practice, including those of the NP.</p><p><strong>Implications for practice: </strong>NPs are in a unique position to test hypothesized terminology for Sensory Processing Disorder (SPD) by contributing precise clinical descriptions of children who match as well as deviate from the criteria for three proposed diagnostic groups: Sensory Modulation Disorder (SMD), Sensory Discrimination Disorder (SDD), and Sensory-Based Motor Disorder (SBMD). Beyond the SPD diagnostic debate, for children with sensory deficit patterns the NP role can incorporate participating in interdisciplinary treatment plans, refining differential diagnoses, providing frontline referral and support for affected children and their families, and making both secondary prevention and critical causal research possible through validation of consistently accepted diagnostic criteria.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"21 6","pages":"314-21"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2009.00417.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28320375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress-induced somatization in spouses of deployed and nondeployed servicemen.","authors":"Tracy Burton,&nbsp;David Farley,&nbsp;Anthony Rhea","doi":"10.1111/j.1745-7599.2009.00411.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2009.00411.x","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the level of perceived stress and somatization experienced by spouses of deployed versus nondeployed servicemen, and to determine the relationship between stress and somatization.</p><p><strong>Data sources: </strong>Using Lazarus and Folkman's theory of Stress and Coping, a descriptive correlational design was used with 130 participants; 68 spouses of nondeployed servicemen and 62 spouses of servicemen deployed to a combat zone. Participants completed a Perceived Stress Scale-10 and Patient Heath Questionnaire-15. An independent t-test was used to determine the level of perceived stress and somatization in each sample. The Pearson's correlation was used to determine the relationship between perceived stress score and level of somatization in the total sample.</p><p><strong>Conclusions: </strong>Spouses of deployed servicemen had significantly higher perceived stress scores than spouses of nondeployed service members (p <.001). Somatization scores were also significantly higher in spouses of deployed versus nondeployed servicemen (p <.001). A significant positive correlation was found between level of perceived stress and level of somatization (r = .878, p <.001).</p><p><strong>Implications for practice: </strong>Providers should be familiar with common somatic symptoms, treatments used for somatization and adjunct community resources available to patients with stress-related somatization.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"21 6","pages":"332-9"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2009.00411.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28320377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}