Journal of the American Academy of Nurse Practitioners最新文献

{"title":"Osteoporosis risk and interest in strength training in men receiving androgen ablation therapy for locally advanced prostate cancer.","authors":"Carol Ott,&nbsp;Melissa K Fulton","doi":"10.111/j.1041-2972.2005.0019.x","DOIUrl":"https://doi.org/10.111/j.1041-2972.2005.0019.x","url":null,"abstract":"<p><strong>Purpose: </strong>The overall purpose of this preliminary study to a clinical trial is to explore the feasibility of recruiting men receiving androgen ablation therapy (AAT) for locally advanced prostate cancer to a future strength training study for the prevention of osteoporosis. The threefold specific purpose of this comparative and correlational study is to (a) describe the prevalence of risk factors for osteoporosis, (b) compare functional status and symptom distress between those interested and not interested in a future strength training study, and (c) examine relationships among self-efficacy for strength training, functional status, symptom distress, years since cancer diagnosis, and cumulative dose of AAT in this at-risk population.</p><p><strong>Method: </strong>Data were obtained from 40 Caucasian men (mean age = 75.8 years) with locally advanced prostate cancer, capable of self-care, and receiving AAT. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaires (QLQ) EORTC QLQ-C30 and EORTC QLQ-PR25 (prostate cancer specific) were used to measure functional status and symptom distress. A 6-item, investigator-developed questionnaire was used to measure self-efficacy for learning and overcoming barriers to strength training.</p><p><strong>Conclusions: </strong>The majority of these men had multiple risk factors for osteoporosis, in addition to receiving AAT, and had not completed bone mineral density (BMD) testing. A high percentage (67.5%) expressed interest in a future strength training protocol for osteoporosis prevention; functional status and symptom distress did not appear to influence this interest. Several aspects of functional status and symptom distress were significantly related to self-efficacy for learning and overcoming barriers to strength training. Years since cancer diagnosis and cumulative dose of AAT were not significantly related to self-efficacy for strength training, but age was related. This study informs a planned future experimental study by establishing the recruitment potential and the decreased likelihood of symptom distress interfering with self-efficacy for participation in strength training.</p><p><strong>Implications for practice: </strong>Advanced practice nurses should complete assessments for osteoporosis risk factors, monitor height loss, order BMD testing and bone enhancing medications, and discuss lifestyle modifications including strength training to improve bone health in men receiving AAT for prostate cancer.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"17 3","pages":"113-22"},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.111/j.1041-2972.2005.0019.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24989244","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":"Pharmacologic treatment options in Alzheimer's disease: optimizing disease management.","authors":"Paul S Aisen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cholinesterase inhibitors and memantine have been shown to improve symptoms associated with AD. Mechanisms of action and the pathophysiologic targets are distinct for the 2 classes, but clinical outcomes demonstrate both medications improve patient symptomatology. In addition, memantine and a ChEI appear to produce an additive effect resulting in a well-tolerated, effective treatment strategy.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"Suppl ","pages":"5-7"},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24911632","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":"Recognizing health risks in childhood cancer survivors.","authors":"Mary Baron Nelson,&nbsp;Kathy Meeske","doi":"10.111/j.1041-2972.2005.0017.x","DOIUrl":"https://doi.org/10.111/j.1041-2972.2005.0017.x","url":null,"abstract":"<p><strong>Purpose: </strong>To provide information about the special health needs of childhood cancer survivors through a discussion of Wilms' tumor, a common childhood renal tumor, and case studies of two survivors of Wilms' tumor, who encountered significant health problems as adults. This information may be generalized to many cancer survivors.</p><p><strong>Data sources: </strong>Actual case studies as well as extensive review of the current literature on childhood cancer survivorship.</p><p><strong>Conclusions: </strong>Adult healthcare practitioners may help to decrease morbidity of childhood cancer survivors in adulthood when they are knowledgeable about the risks of this population. Resources are readily available, both in the medical literature and on the Internet.</p><p><strong>Implications for practice: </strong>With well-established success in the treatment of childhood cancer, there are many young and middle-aged adult survivors of the disease. However, as many as two-thirds of survivors may have chronic long-term effects of treatment. Most survivors eventually discontinue follow-up with their pediatric oncologists and receive primary health care from adult providers, many of whom are unaware of survivors' health risks. Awareness of primary care providers regarding the special health needs of childhood cancer survivors is critical to decrease morbidity and improve quality of life. The ever-increasing number of childhood cancer survivors is creating a public health issue as they transition into adulthood.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"17 3","pages":"96-103"},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.111/j.1041-2972.2005.0017.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24989242","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":"Homocysteine and cardiovascular disease: a review of current recommendations for screening and treatment.","authors":"Karen L Chamberlain","doi":"10.111/j.1041-2972.2005.0016.x","DOIUrl":"https://doi.org/10.111/j.1041-2972.2005.0016.x","url":null,"abstract":"<p><strong>Purpose: </strong>To review the literature for, and provide advanced practice nurses (APNs) with, current recommendations for screening and treatment of hyperhomocysteinemia.</p><p><strong>Data sources: </strong>Medscape literature search of selected research studies and related journal articles.</p><p><strong>Conclusions: </strong>While data from most epidemiologic studies support the argument that hyperhomocysteinemia is an independent risk factor for cardiovascular disease, the debate continues as to when screening and treating patients is appropriate. The consensus is that more randomized controlled trials are needed to further study the benefits of routine screening and the efficacy of treating hyperhomocysteinemia.</p><p><strong>Implications for practice: </strong>Until the results of ongoing clinical trials are available, APNs should follow the American Heart Association guidelines for screening for elevated levels of homocysteine and continue to promote a well-balanced diet that includes foods rich in folic acid as part of health promotion through primary prevention.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"17 3","pages":"90-5"},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.111/j.1041-2972.2005.0016.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24989916","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":"Alzheimer's disease care management plan: maximizing patient care.","authors":"Anna Treinkman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nurse practitioners have the potential to significantly impact the care of patients with dementia. Healthcare providers can now offer patients medications that will control symptoms and prolong functioning. As a result of ongoing contact with patients, NPs play an important role in assessing and screening patients for AD and educating the patients, families, and caregivers about the disease. Alzheimer's disease is a chronic, progressive illness that requires long-term management. Nurse practitioners should be familiar with available medications and appreciate the need to individualize therapy to maximize efficacy and minimize potential adverse drug reactions.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"Suppl ","pages":"8-9"},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24911634","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":"Current perspectives on management of urgency using bladder and behavioral training.","authors":"Kathryn L Burgio","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Behavioral interventions for overactive bladder (OAB) include bladder training and behavioral training. Bladder training focuses on modifying bladder function by changing voiding habits; a bladder diary is indispensable. Behavioral training focuses on improving voluntary control rather than bladder function. It works through modification of the bladder outlet using methods, such as pelvic floor muscle training and urge suppression strategies to inhibit detrusor (bladder) muscle contraction. Behavioral methods--with biofeedback (which requires instrumentation), verbal feedback during a pelvic examination (using vaginal or anal palpation), or electrical stimulation--appear to be at least as effective in terms of reducing incontinence episodes as currently available drug therapy. However, evidence suggests that combining behavioral and drug therapy may produce better results than either approach alone. More research is needed to elucidate the role of behavioral modification in reducing urgency, frequency, and nocturia.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"16 10 Suppl","pages":"4-7"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24814034","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":"Stating the case for overactive bladder: a nurse practicioner's perspective.","authors":"Diane K Newman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Overactive bladder (OAB) is a widespread syndrome characterized by symptoms of urgency, with or without urge urinary incontinence, frequency of micturition, and nocturia. Urgency is a sudden, intense, difficult-to-defer desire to pass urine and must be differentiated from normal urge or desire to void that can be deferred. It is the core symptom of OAB in the International Continence Society definition. Many misconceptions surround OAB, including that it is a normal part of aging; these contribute to the barriers to OAB diagnosis. Women are more likely than men to have OAB with incontinence; these women report diminished quality of life and are more susceptible to sleep disorders, fractures, and infections. The nurse practitioner plays an important role in diagnosing OAB during examination by eliciting specific information about symptoms from patients in their care, and in determining which treatment approaches (i.e., behavioral, pharmacologic, or a combination of both) will help them achieve optimal outcomes.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"16 10 Suppl","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24814033","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":"Elevating our therapeutic expectations in overactive bladder.","authors":"Peter K Sand","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Drug therapy for overactive bladder (OAB) most commonly includes antimuscarinic agents, which work by relaxing bladder smooth muscle through inhibition of acetylcholine receptors in the bladder. The major adverse effects with existing antimuscarinic agents are anticholinergic in nature (e.g., dry mouth, constipation, blurred vision). Oxybutynin and tolterodine have been used for several years for treatment of OAB; both are available in immediate- and extended-release formulations. Fewer or less severe adverse effects are reported with the extended- versus the immediate-release formulations, with little or no difference in efficacy. Oxybutynin is also available as a transdermal patch. Trospium, which was recently approved for use in the United States, has efficacy and an incidence of dry mouth similar to existing agents but does not cross the blood-brain barrier. It requires twice-daily dosing. Two new antimuscarinic agents--darifenacin and solifenacin--are in development. Both show significantly better efficacy compared with placebo for key symptoms of OAB, including urgency. The incidence of dry mouth at the lowest effective dose is 19% for darifenacin and 8% and 14% for solifenacin (2 studies).</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"16 10 Suppl","pages":"8-11"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24814035","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":"Nurse-managed primary care: outcomes of a faculty practice network.","authors":"Joellen B Edwards,&nbsp;Sonda Oppewal,&nbsp;Carol Lee Logan","doi":"10.1111/j.1745-7599.2003.tb00349.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2003.tb00349.x","url":null,"abstract":"<p><strong>Purpose: </strong>To describe selected outcomes of nurse-managed primary care in a large faculty practice network (FPN) and to use guidelines proposed by the National Organization of Nurse Practitioner Faculties (NONPF) to evaluate those outcomes.</p><p><strong>Data sources: </strong>Mission and goals, nursing control, fiscal stability, health care outcomes, and faculty role integration were examined.</p><p><strong>Conclusions: </strong>Outcomes show that the FPN directly supports the mission and goals of the East Tennessee State University College of Nursing and is managed by nurse faculty members. The FPN uses earned revenue, grants, and contracts to maintain fiscal stability. Patients are highly satisfied with services, and external and internal audits find the quality of care to be excellent. Students are educated in the centers. Faculty members publish and present research and other scholarly work derived from the FPN.</p><p><strong>Implications for practice: </strong>This model demonstrates that faculty practice can work, can meet the evaluation components of guidelines of a major national organization, and can contribute to the improvement of health for vulnerable populations.</p>","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"15 12","pages":"563-9"},"PeriodicalIF":0.0,"publicationDate":"2003-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2003.tb00349.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24410815","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":"Nurse practitioner practice in 2003.","authors":"Jan Towers","doi":"10.1111/j.1745-7599.2003.tb00343.x","DOIUrl":"https://doi.org/10.1111/j.1745-7599.2003.tb00343.x","url":null,"abstract":"","PeriodicalId":50020,"journal":{"name":"Journal of the American Academy of Nurse Practitioners","volume":"15 12","pages":"530-5"},"PeriodicalIF":0.0,"publicationDate":"2003-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1745-7599.2003.tb00343.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24410808","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}