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014—The Effectiveness of Computer-Assisted Instruction
156
RESEARCH
014—The Effectiveness of Computer-Assisted Instruction. Deborah P. Rouse, MSN, RN-BC, Associate Professor, University of Cincinnati, Raymond Walters College, Cincinnati, OH
research can offer insight into how these decisions are made and what parental informational needs are.
It has been documented that by seeing, hearing, and interacting in the learning process, students improve their learning. The teaching methodology of computerassisted instruction (CAI) supports this learning process by incorporating audio, visuals, and interaction. As a nursing instructor, I developed a CAI for nursing students that incorporated these elements in the hopes of improving their understanding of the difficult subject of congenital heart disease (CHD). In 1999, I conducted a study that compared the use of traditional lecture method (TLM) and CAI in teaching CHD to associate degree nursing students using my CAI. The results supported the effectiveness of TLM and CAI equally. Considering the advancement in computer technology and computer literacy by students over the last 7 years, there is a need to determine the effectiveness of CAI usage with present-day nursing students using systematic inquiry. The purpose of this study was to determine the effectiveness of CAI and TLM in teaching nursing students about CHD. The participants of the study were associate degree nursing students enrolled in a family nursing course at University of Cincinnati Raymond Walters College. Twenty-five students participated during the winter of 2006, receiving instruction through TLM, and 30 students participated during the autumn of 2006, receiving instruction through CAI. The study was conducted in the classroom during a scheduled class time. Paper-and-pencil, multiple-choicequestion pretest and posttest were used to measure the performance of the students in both groups. The results of the study indicated that both TLM and CAI are equally effective when teaching students about but CHD. This is the same result found in the 1999 study. If TLM and CAI are equally effective, it could be hypothesized that by combining the two methods, learning would increase. The second part of my study, which will be done in the winter of 2007, will test this hypothesis.
016—Nurses’ Perceptions of Pediatric Pain Assessment Scales. Patricia L. Schaffer, MSN, RN, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
015—Life Support Decisions for Extremely Premature Infants: Who Decides? Teresa A. Savage, PhD, RN, T. Savage K. Kavanaugh, T. Moro, R. Bhat, R. deRegnier, W. Grobman M. Hussey, S. Kilpatrick R. Kimura, College of Nursing, University of Illinois at Chicago, Chicago, IL
017—Clinical Utility of a Structured Psychosocial Assessment Guide for Children and Their Families Undergoing Treatment for Leukemia: A Pilot Study. Andrea Smith, PhD, RN, CPNP, Lisa Bashore, MS, RN, CPNP CPON, Jill Koss, MS, CCLS, Cook Children’s Medical Center, Fort Worth, TX
Purpose: The objectives of this poster are to explore the meaning of shared decision making and to look at how decisions are made for extremely premature infants. Abstract: A model of shared decision making between parents and health care professionals is recommended when they are faced with making life support decisions for the anticipated birth of an extremely premature infant. These decisions include ones made prenatally and postnatally for pregnancy management and care of the infant. Despite this preferred model of decision making, the literature reveals some discrepancy regarding who is actually making these decisions. Using the Ottawa Decision Support Framework, the purpose of this study is to explore life support decisions for extremely premature infants from the perspectives of parents, nurses, and physicians. This longitudinal multisite study uses a prospective, collective case study approach to collect data from 40 cases (parents, obstetrical and neonatal nurses, obstetrical and neonatal physicians) from the prenatal to the postnatal period. Thus far, we have recruited 20 cases and have conducted 41 interviews with 25 parents and 46 interviews with physicians and nurses. Using a within- and across-case approach to the data, preliminary analysis reveals that many parents feel that they are participating, to some degree, in decision making for themselves and their baby. In addition to deciding the route of delivery and full intervention for the baby, prenatally, parents perceive that one of the most important decisions is whether or not to place or maintain a cervical cerclage. Postnatally, parents recall giving consent for procedures such as blood transfusions but do not report that they are being asked to make other life support decisions because, for many, they have given their consent to bdo everythingQ for the infant. Most parents make both prenatal and postnatal decisions after being given information by physicians, and some go against the advice they receive from physicians. Many parents do not follow or elicit any additional advice from friends and family. In this study, nurses are often viewed by both parents and health care professionals as primarily providing support to parents. Because nurses play an integral role in parents’ ability to understand and make informed choices, this
Purpose: This study aimed to examine the clinical utility and impact on quality of life of a structured psychosocial assessment guide for childhood cancer (PAGCC) developed by the researchers, which operationalized the conceptual model by Lauria, Hockenberry-Eaton, Pawletko, and Mauer (1995). The 40 items on the PAGCC addressed educational, neurocognitive, developmental, spiritual, social, and emotional needs of children and families. Method: Using a quasi-experimental design, 20 children and adolescents (ages 2–18 years) diagnosed with acute lymphoblastic leukemia (ALL) were randomly assigned to either a treatment group or a control group. The treatment group received a comprehensive interview using the PAGCC at baseline and at 3, 6, 9, and 12 months following the diagnosis of ALL. The control group received standard cancer care services. The Quality of Life study described in this article was carried out using the PedsQLTM, developed by Dr. James W. Varni (1998). The Pediatric Oncology Quality of Life Scale (Goodwin et al., 1994) was also used. Quality of life was measured at baseline and 12 months in both groups. Findings: The sample consisted of 12 males (60%) and 8 females (40%), with a median age of 5.45 years. Financial concerns and changes in relationships had the greatest impact on families. Parents identified the need for more formal support programs for the patients and their siblings, counseling, and resources. Lack of control over the situation, guilt, lack of support, and bnot knowingQ were identified as difficult aspects of the child’s cancer experience. Using the guide, multiple referral needs for the treatment group were identified during the first 12 months, including education (n = 7), neuropsychological testing (n = 13), financial and psychosocial services (n = 17), emotional/coping support (n = 17), and spiritual services (n = 2). There were no significant differences in QOL scores between the treatment and control groups at 12 months. Conclusions: The PAGCC was a clinically useful guide for nurses and the health care team to formally identify and address the psychosocial and emotional issues confronting children undergoing ALL therapy and their families.
Purpose: The purpose of this study is to survey nurses’ perceptions of ease of use and effectiveness of five pain assessment scales currently in use at Cincinnati Children’s Hospital Medical Center (CCHMC). The scales are the Neonatal Infant Pain Scale, the Children’s Hospital of Eastern Ontario Pain Scale, the Oucher Scale, the Visual Analog Scale, and the COMFORT Scale. Methods: An electronic survey was used to survey RNs who provided direct patient care in inpatient, outpatient, emergency, and home health settings of the medical center. The survey was accessible for 4 weeks with links provided in e-mail. Responders were asked to rate the ease of use and the effectiveness of each pain scale. They were given the opportunity to provide descriptive comments or suggestions about the current pain assessment scales and to suggest alternative scales. Findings: The response rate was 66.4% (829 responses). Most responders rated the scales as easy to use and moderately effective in assessing pain. However, they raised issues regarding use of the scales and offered suggestions for improvement. The nurses’ comments are undergoing analysis for themes. Conclusions: A preliminary conclusion is to trial the FLACC scale at CCHMC. Further analysis of results will guide future use of pain assessment scales at the medical center. Significance: There are few studies of nurses’ perceptions of multiple pain scales following implementation of standardized pain assessment tools. This study will provide a comparison of pain scales from the nurse’s perspective, which may impact actual use.
RESEARCH
014—The Effectiveness of Computer-Assisted Instruction. Deborah P. Rouse, MSN, RN-BC, Associate Professor, University of Cincinnati, Raymond Walters College, Cincinnati, OH
research can offer insight into how these decisions are made and what parental informational needs are.
It has been documented that by seeing, hearing, and interacting in the learning process, students improve their learning. The teaching methodology of computerassisted instruction (CAI) supports this learning process by incorporating audio, visuals, and interaction. As a nursing instructor, I developed a CAI for nursing students that incorporated these elements in the hopes of improving their understanding of the difficult subject of congenital heart disease (CHD). In 1999, I conducted a study that compared the use of traditional lecture method (TLM) and CAI in teaching CHD to associate degree nursing students using my CAI. The results supported the effectiveness of TLM and CAI equally. Considering the advancement in computer technology and computer literacy by students over the last 7 years, there is a need to determine the effectiveness of CAI usage with present-day nursing students using systematic inquiry. The purpose of this study was to determine the effectiveness of CAI and TLM in teaching nursing students about CHD. The participants of the study were associate degree nursing students enrolled in a family nursing course at University of Cincinnati Raymond Walters College. Twenty-five students participated during the winter of 2006, receiving instruction through TLM, and 30 students participated during the autumn of 2006, receiving instruction through CAI. The study was conducted in the classroom during a scheduled class time. Paper-and-pencil, multiple-choicequestion pretest and posttest were used to measure the performance of the students in both groups. The results of the study indicated that both TLM and CAI are equally effective when teaching students about but CHD. This is the same result found in the 1999 study. If TLM and CAI are equally effective, it could be hypothesized that by combining the two methods, learning would increase. The second part of my study, which will be done in the winter of 2007, will test this hypothesis.
016—Nurses’ Perceptions of Pediatric Pain Assessment Scales. Patricia L. Schaffer, MSN, RN, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
015—Life Support Decisions for Extremely Premature Infants: Who Decides? Teresa A. Savage, PhD, RN, T. Savage K. Kavanaugh, T. Moro, R. Bhat, R. deRegnier, W. Grobman M. Hussey, S. Kilpatrick R. Kimura, College of Nursing, University of Illinois at Chicago, Chicago, IL
017—Clinical Utility of a Structured Psychosocial Assessment Guide for Children and Their Families Undergoing Treatment for Leukemia: A Pilot Study. Andrea Smith, PhD, RN, CPNP, Lisa Bashore, MS, RN, CPNP CPON, Jill Koss, MS, CCLS, Cook Children’s Medical Center, Fort Worth, TX
Purpose: The objectives of this poster are to explore the meaning of shared decision making and to look at how decisions are made for extremely premature infants. Abstract: A model of shared decision making between parents and health care professionals is recommended when they are faced with making life support decisions for the anticipated birth of an extremely premature infant. These decisions include ones made prenatally and postnatally for pregnancy management and care of the infant. Despite this preferred model of decision making, the literature reveals some discrepancy regarding who is actually making these decisions. Using the Ottawa Decision Support Framework, the purpose of this study is to explore life support decisions for extremely premature infants from the perspectives of parents, nurses, and physicians. This longitudinal multisite study uses a prospective, collective case study approach to collect data from 40 cases (parents, obstetrical and neonatal nurses, obstetrical and neonatal physicians) from the prenatal to the postnatal period. Thus far, we have recruited 20 cases and have conducted 41 interviews with 25 parents and 46 interviews with physicians and nurses. Using a within- and across-case approach to the data, preliminary analysis reveals that many parents feel that they are participating, to some degree, in decision making for themselves and their baby. In addition to deciding the route of delivery and full intervention for the baby, prenatally, parents perceive that one of the most important decisions is whether or not to place or maintain a cervical cerclage. Postnatally, parents recall giving consent for procedures such as blood transfusions but do not report that they are being asked to make other life support decisions because, for many, they have given their consent to bdo everythingQ for the infant. Most parents make both prenatal and postnatal decisions after being given information by physicians, and some go against the advice they receive from physicians. Many parents do not follow or elicit any additional advice from friends and family. In this study, nurses are often viewed by both parents and health care professionals as primarily providing support to parents. Because nurses play an integral role in parents’ ability to understand and make informed choices, this
Purpose: This study aimed to examine the clinical utility and impact on quality of life of a structured psychosocial assessment guide for childhood cancer (PAGCC) developed by the researchers, which operationalized the conceptual model by Lauria, Hockenberry-Eaton, Pawletko, and Mauer (1995). The 40 items on the PAGCC addressed educational, neurocognitive, developmental, spiritual, social, and emotional needs of children and families. Method: Using a quasi-experimental design, 20 children and adolescents (ages 2–18 years) diagnosed with acute lymphoblastic leukemia (ALL) were randomly assigned to either a treatment group or a control group. The treatment group received a comprehensive interview using the PAGCC at baseline and at 3, 6, 9, and 12 months following the diagnosis of ALL. The control group received standard cancer care services. The Quality of Life study described in this article was carried out using the PedsQLTM, developed by Dr. James W. Varni (1998). The Pediatric Oncology Quality of Life Scale (Goodwin et al., 1994) was also used. Quality of life was measured at baseline and 12 months in both groups. Findings: The sample consisted of 12 males (60%) and 8 females (40%), with a median age of 5.45 years. Financial concerns and changes in relationships had the greatest impact on families. Parents identified the need for more formal support programs for the patients and their siblings, counseling, and resources. Lack of control over the situation, guilt, lack of support, and bnot knowingQ were identified as difficult aspects of the child’s cancer experience. Using the guide, multiple referral needs for the treatment group were identified during the first 12 months, including education (n = 7), neuropsychological testing (n = 13), financial and psychosocial services (n = 17), emotional/coping support (n = 17), and spiritual services (n = 2). There were no significant differences in QOL scores between the treatment and control groups at 12 months. Conclusions: The PAGCC was a clinically useful guide for nurses and the health care team to formally identify and address the psychosocial and emotional issues confronting children undergoing ALL therapy and their families.
Purpose: The purpose of this study is to survey nurses’ perceptions of ease of use and effectiveness of five pain assessment scales currently in use at Cincinnati Children’s Hospital Medical Center (CCHMC). The scales are the Neonatal Infant Pain Scale, the Children’s Hospital of Eastern Ontario Pain Scale, the Oucher Scale, the Visual Analog Scale, and the COMFORT Scale. Methods: An electronic survey was used to survey RNs who provided direct patient care in inpatient, outpatient, emergency, and home health settings of the medical center. The survey was accessible for 4 weeks with links provided in e-mail. Responders were asked to rate the ease of use and the effectiveness of each pain scale. They were given the opportunity to provide descriptive comments or suggestions about the current pain assessment scales and to suggest alternative scales. Findings: The response rate was 66.4% (829 responses). Most responders rated the scales as easy to use and moderately effective in assessing pain. However, they raised issues regarding use of the scales and offered suggestions for improvement. The nurses’ comments are undergoing analysis for themes. Conclusions: A preliminary conclusion is to trial the FLACC scale at CCHMC. Further analysis of results will guide future use of pain assessment scales at the medical center. Significance: There are few studies of nurses’ perceptions of multiple pain scales following implementation of standardized pain assessment tools. This study will provide a comparison of pain scales from the nurse’s perspective, which may impact actual use.