Medical-surgical Care Research Articles

Sexuality in Adolescents with Chronic Illness

MS. FRAUMAN, R.N., M.S.N., AND MS. SYPERT, R.N., M.N., are both assistant professors at the University of Florida College of Nursing in Gainesville. Ms. Frauman, who teaches pediatrics on the graduate level, also serves as consultant to the pediatric renal failure program. Ms. Sypert, whose area of practice is medical surgical care, teaches a course on human sexuality for nurses and counsels medical and surgical patients who have related sexual concerns.

Interpersonal Attraction and Perceived Quality of Medical-Surgical Care

Interpersonal Attraction and Perceived Quality of Medical-Surgical Care

Commentary

Commentary

Commentary

Commentary

Field Testing the Nursing Quality Monitoring Methodology

The design, analysis, and findings of a field test of a methodology for monitoring quality of nursing care are presented. Quality care scores for types of patients (self-care, partial care, complete care, intensive care), types of units (medical, surgical, medical-surgical, pediatric, and intensive care), and shifts (day, evening, and night) showed the method to be useful.

Integrated Medical-Surgical Care in Acute Coronary Artery Disease.

Integrated Medical-Surgical Care in Acute Coronary Artery Disease.

Medical-Surgical Day Care Unit

A five-day or day care unit in a general hospital is a relatively new concept. In our short-term-admission unit at the University of Rochester Medical Center, in Rochester, New York, nurses care for selected medical and surgical patients. Made over from a solarium, the five-bed unit is one open area with curtains to form cubicles as needed. Minimum equipment and provisions are necessary. A fully equipped emergency cart remains in the unit, and we can provide liquid or light diets for patients. Surgery is performed in the regular operating rooms, and a period in the recovery room follows before patients return to the unit.

Medical-Surgical Day Care Unit

Medical-Surgical Day Care Unit

¿Existe disfunción eréctil posterior al manejo quirúrgico en la fractura de pene? Evaluación funcional y de la satisfacción sexual

Introducción: La fractura de pene (FP) es una emergencia urológica que se conceptualiza como la ruptura de la túnica albugínea del cuerpo cavernoso en erección con o sin afectación uretral. El objetivo de este estudio es describir la preservación de la función eréctil en pacientes con antecedentes de fractura de pene manejados con reparación quirúrgica.
 Material y Métodos: Estudio observacional, descriptivo, analítico y retrospectivo de pacientes atendidos en el Departamento de Urología del Hospital General de México, durante el período de 2005 a 2019 con diagnóstico de fractura de pene. Un total de 32 expedientes clínicos tratados en nuestra unidad, analizando las siguientes variables: edad al momento de la fractura, preferencia sexual, estado civil, mecanismo de trauma, condición anatómica, tiempo de atención médico-quirúrgica, tiempo de recuperación, curvatura del pene, disfunción eréctil -IIEF-5-, fibrosis o estenosis uretral como complicaciones postraumáticas y seguimiento temporal. Resultados: El mecanismo de lesión presentado por los pacientes fue el coito 24 (75%), la promiscuidad estuvo presente en 16 casos (50%). Con respecto a la preferencia sexual, se registraron 31 casos como heterosexuales (97%), la posición sexual más frecuente asociada con fractura de pene fue "emparejarse" con 12 pacientes (38%). La mayoría de los 6 (19%) tenía un tiempo de atención quirúrgica registrado en 720 minutos (30 horas). La reanudación de las relaciones sexuales se informó en promedio dos meses ± 1.3 meses, después del trauma. Del total de pacientes, la gran mayoría permanece sin disfunción eréctil 19 (60%).
 Conclusión: La mayoría de los pacientes que reciben atención quirúrgica oportuna al momento del diagnóstico (menos de 35 horas) tendrán un mejor pronóstico y un resultado favorable en términos de función eréctil, evitando así las secuelas de la fractura.

A practical application of credibility to experience rating plans for hospitalization and medical-surgical insurance

This paper describes a rather simple application of credibility which was used to develop experience rating plans for Blue Cross and Blue Shield organizations in the United States. These are non-profit corporations which provide prepaid coverage for the cost of hospitalization and medical-surgical care. The benefits are in many instances full service benefits so that there is no additional cost to the subscribing member.While coverage is being granted to individual applicants, the bulk of the unterwriting is composed of groups, that is employees of a given commercial entity. Since the plans are voluntary and, in many instances, the employer either acts only as collecting agent for his employees or else pays only a fraction of the premium, certain minimum participation percentages have been established to prevent anti-selection.Because of the competion of Insurance Companies which have concentrated their efforts on larger and more profitable groups (especially those where the employer pays all of the premiums) it was early recognized that a uniform or “community” rate will result in a gradual loss of groups with good experience thereby requiring substantial increases in the average rates. The original program of experience rating which the author has developed for the Massachusetts Blue Cross in 1949 has been since adopted “mutatis mutandis” by a number of other Blue Cross and Blue Shield organizations.

Cerebral palsy: A re-evaluation

There has been an increasing interest in the problems of the individual with cerebral palsy. Since 1945 there has been an organized cerebral palsy program in the State of California which has provided for the establishment of specialized diagnostic centers, the construction of residence schools, the development of special education, training facilities in the public schools, and medical-surgical care in connection with cerebral palsy. The program has been a responsibility of the State and local Departments of Education as well as the State and local departments of public health. Special diagnostic facilities have been available at the University of California Medical Center as well as other medical centers. It has become apparent that individuals with cerebral palsy may have sensory, mental, and emotional problems which may interfere with the prognosis and eventual habilitation of the individual; emotional factors may be the most limiting in relation to the eventual vocational placement and independence. Traditional therapy—physical, occupational, or speech—will not solve the problems of the child with cerebral palsy and his family. Good social counseling is necessary to strengthen the family and to prevent an adverse effect on the emotions of the child. Development of more programs for the preschool child where medical, psychiatric, and social services are available would be helpful. When the child reaches school age, there should be a constant review in order to select those children for regular school who need a minimum of therapy, and continued counseling should be available for those families where the dependency of the child continues beyond the need. For those children who show some hope of being educable, appropriate counseling should be made available to plan for a reasonable vocation and eventual referral to a state vocational rehabilitation service.