14 hours ago 20 Select the best desired outcome for a patient who uses valerian a The patient from NURSING 1210 at University of California, Los Angeles. Study Resources. Main Menu; by School; by Literature Title; by Subject; Textbook Solutions Expert Tutors Earn. Main Menu; Earn Free Access; >> Go To The Portal
This change in patient’s self-evaluation of outcome criterion represents a response shift [8–10]. This psychological phenomenon occurrs during the course of treatment as patients adapt and attain knowledge of their musculoskeltal condition [10]. Recognizing that patient’s self evaluation of treatment outcome may change during the course of treatment may lead to more accurate interpretations of the effectiveness of rehabilitation [10].
Desired and expected change was calculated by subtracting subject’ desired and expected levels of impairment following treatment from subjects’ usual levels of impairment at initial intake. One-way ANOVA with Scheffe post-hoc testing were also used to assess whether subject’s success criteria differed from their expected and desired outcomes.
At the initial intake physical therapy session, subjects completed the Patient Centered Outcome Questionnaire (PCOQ) (Additional file 1), which obtains the patient’s perspective of treatment goals across four constructs (pain, fatigue, emotional distress, and interference with daily activities) and assesses how each of these areas has impacted the patient and what the patient’s definition of expected, successful, and desired outcomes are following their rehabilitation treatment [1–4]. Additionally, subjects completed a standard medical and demographic questionairre, as well as outcome measures matched to patient presentation and appropriate for region of symptoms, the Tampa Scale for Kniesophobia-11 (TSK-11), and the Short Form of the Medical Studies −8 (SF-8). All questionairres were given out as part of routine clinical care and patient-assessment, prior to initiation of treatment. Patients also completed the Follow-up PCOQ, TSK-11, SF-8 and region specific outcome measure at discharge. In addition, all patients treated at the University of Florida Orthopeadic and Sports Medicine Institute sign a global IRB approved by the University of Florida Institutional Review Board prior to initiating treatment. This global IRB allows for use of data from questionnaires related to injury that measure pain, functional, and psychological outcomes in a de-identified manner. The de-identified clinical data were then entered into a clinical data bank before analysis.
All analyses were performed with SPSS version 20.0 (Chica go, IL) with a α = .01 due to the number of comparisons. Descriptive statistics were calculated for selected demographic and clinical factors and reported as mean and standard deviation for continuous variables or frequency for categorical variables. Normality of PCOQ domains was assessed with one-sample Kolmogorov-Smirnov tests.
A patient-centered approach emphasizes patient’s desires, beliefs, and expectations and utilizes them in making decisions on what constitutes a successful treatment outcome [1]. A model with the patient as the centerpiece of outcome driven decisions may have advantages when assessing treatment outcomes. Patient-centered models allow patients more control in directing their treatment and are a viable alternative method in determining the success of treatment outcomes [1–6]. A patient-centered approach has the potential to lead to increased satisfaction, enhanced patient-practitioner interaction, greater treatment compliance, and a positive treatment response [4–7].
The results revealed no change in success criteria pre to post treatment for all domains. Chi-square test revealed patients desired, expected, and success criteria were independent of established MCIDs (P > .01). There were no differences between patients expected outcomes and success criteria. However, there were differences between patient’s desired outcomes and expected and success outcomes, with patients reporting lower desired levels of pain, emotional distress, fatigue, and interference with daily activities following physical therapy intervention (P < .01).
Helping consumers actively evaluate the quality of information available to them is important. It is important for the nurse to work with the patient and include the patient's preferences regarding management of health. Advertisements indicating scientific breakthroughs or promising miracles for multiple ailments are usually for products that are useless and being fraudulently marketed. Some may even be harmful. Some over-the-counter products can be useful, and patients do not need a prescription for these products. The broader issue is safety and efficacy, rather than whether the patient is trying to self-medicate.
The nurse should reinforce the patient for reporting use of the herb. Many patients keep secrets about use of alternative therapies. If it poses no danger , the nurse can document the use. The patient may also get placebo effect from the herb, but it is not necessary for the nurse to point out that information. The distracters are judgmental and may discourage the patient from openly sharing in the future.
Angelica is contraindicated in diabetes. The patient should identify other strategies to manage anxiety. The other options imply that this herb is safe to use in this situation.
Valerian decreases sleep latency and nocturnal awakening, and it leads to a subjective sense of good sleep. Sleeping through the night is the best indicator that the herb was effective. The herb is not associated with the conditions identified by the other options.
Valerian is thought to negate the effects of several drugs, including phenytoin, making an increase in seizures probable. The other outcomes are not associated with valerian use, though they are associated with phenytoin.