Pilot Outcome Study Research Articles

The effect of early adoption of an academic electronic health record system in nursing education: A pilot outcome study

Objective: This study aimed to explore the faculty’s and students’ perceptions of an academic electronic health record system (AEHRs) for teaching/learning electronic nursing documentation and to assess the outcomes of the AEHRs on nursing students’ competency with electronic nursing documentation.Methods: With a mixed-method pilot study, a convenience sample of 41 undergraduate nursing students and a purposive sample of 7 faculty and 9 students were used. Two groups of student participants for the quantitative data were compared for their competency with electronic nursing documentation. For the qualitative data, an in-depth, exploratory approach to data collection was taken for the nursing faculty and the intervention group.Results: For the quantitative findings, the early adoption of an AEHRs could help students to collect a patients’ health information through the system even though it may not impact their critical thinking on a patient’s care. For the qualitative findings, three key themes were shared by the faculty and students: (1) benefits and challenges, (2) impact of the AEHRs, and (3) recommendations for future adoption.Conclusions: This study revealed that the successful adoption of an AEHRs includes many steps that can be used to create positive improvements. These findings were beneficial to prepare students and nursing educators for the future of health information technology. Meaningful adoption of an AEHRs will help in building the competence of undergraduate nursing students in electronic nursing documentation and improve patient care.

Lidocaine With Epinephrine Versus Bupivacaine With Epinephrine as Local Anesthetic Agents in Wide-Awake Hand Surgery: A Pilot Outcome Study of Patient’s Pain Perception

PurposeWide-awake local anesthesia hand surgery has many advantages over other forms of anesthesia, including faster recovery, lower cost, and improved patient safety; however, few studies compare postoperative pain and analgesic consumption after long- and short-acting anesthetics. This is important because surgeons seek to minimize opioid consumption during the opioid epidemic.MethodsThis was a double-blinded, prospective, randomized, parallel design pilot study. We randomized 61 patients to receive carpal tunnel surgery with a short-lasting regional anesthetic (lidocaine, 29 patients) or a long-lasting one (bupivacaine, 32 patients). Primary outcomes were pain levels over the first and second 24 hours. Secondary outcomes were postoperative consumption of acetaminophen and opioids over the first and second 12 hours after surgery.ResultsPain intensity and acetaminophen consumption were significantly less in the bupivacaine group over the first 24 and 12 hours after surgery, respectively. The bupivacaine group consumed less opioids in the first 12 hours and delayed consumption of the first medication after surgery, but these results were not statistically significant. There was no difference in pain intensity or analgesic consumption between 24 and 48 hours after surgery.ConclusionsThe use of a long-term anesthetic (bupivacaine) over a short-term one (lidocaine) in awake carpal tunnel release surgery decreases postoperative pain over the initial 12 hours after surgery and delays the initiation of analgesic consumption; however, this difference is small. The amount of opioid consumption was not significantly different between groups, but both groups consumed less than 10% of the prescribed opioids. It is important to reevaluate the need for opioids in minor hand surgery and favor the use of alternatives such as nonsteroidal anti-inflammatory drugs and acetaminophen.Type of study/level of evidenceTherapeutic I.

The Role of Theistic Spirituality in Adolescent Girls' Body Esteem: A Pilot Outcome Study

A pilot outcome study explored associations between psychospiritual variables and body esteem in adolescent girls at a Roman Catholic high school by examining the influence of The Imago Dei Experience (TIDE), an intervention program the first author designed. Perception of God's loving acceptance accounted for significant variance in weight and appearance body esteem; religious crisis accounted for significant variance in weight body esteem. Lack of significant changes in body esteem from pretest to 18‐month follow‐up suggested the TIDE program may have buffered the typical increase in body dissatisfaction over that period of time for adolescent girls. The authors recommend counselors explore qualities of God image and religious crisis with adolescent girls.

Delineation of epicardial stenosis in patients with microvascular disease using pressure drop coefficient: A pilot outcome study.

AIMTo investigate the patient-outcomes of newly developed pressure drop coefficient (CDP) in diagnosing epicardial stenosis (ES) in the presence of concomitant microvascular disease (MVD).METHODSPatients from our clinical trial were divided into two subgroups with: (1) cut-off of coronary flow reserve (CFR) < 2.0; and (2) diabetes. First, correlations were performed for both subgroups between CDP and hyperemic microvascular resistance (HMR), a diagnostic parameter for assessing the severity of MVD. Linear regression analysis was used for these correlations. Further, in each of the subgroups, comparisons were made between fractional flow reserve (FFR) < 0.75 and CDP > 27.9 groups for assessing major adverse cardiac events (MACE: Primary outcome). Comparisons were also made between the survival curves for FFR < 0.75 and CDP > 27.9 groups. Two tailed chi-squared and Fischer’s exact tests were performed for comparison of the primary outcomes, and the log-rank test was used to compare the Kaplan-Meier survival curves. P < 0.05 for all tests was considered statistically significant.RESULTSSignificant linear correlations were observed between CDP and HMR for both CFR < 2.0 (r = 0.58, P < 0.001) and diabetic (r = 0.61, P < 0.001) patients. In the CFR < 2.0 subgroup, the %MACE (primary outcomes) for CDP > 27.9 group (7.7%, 2/26) was lower than FFR < 0.75 group (3/14, 21.4%); P = 0.21. Similarly, in the diabetic subgroup, the %MACE for CDP > 27.9 group (12.5%, 2/16) was lower than FFR < 0.75 group (18.2%, 2/11); P = 0.69. Survival analysis for CFR < 2.0 subgroup indicated better event-free survival for CDP > 27.9 group (n = 26) when compared with FFR < 0.75 group (n = 14); P = 0.10. Similarly, for the diabetic subgroup, CDP > 27.9 group (n = 16) showed higher survival times compared to FFR group (n = 11); P = 0.58.CONCLUSIONCDP correlated significantly with HMR and resulted in better %MACE as well as survival rates in comparison to FFR. These positive trends demonstrate that CDP could be a potential diagnostic endpoint for delineating MVD with or without ES.

Seeking Safety Pilot Outcome Study at Walter Reed National Military Medical Center

Post-traumatic stress disorder (PTSD) and substance use disorder are two of the most prominent psychiatric disorders among military service members. Seeking Safety (SS) is an evidence-based behavioral therapy model for this comorbidity. This article reports results of a study of SS conducted in a military setting. Our pilot trial addressed outcomes, feasibility, and satisfaction. SS was conducted as is to evaluate its impact without adaptation for military culture. The sample was 24 outpatient service members (from the Army, Navy, Air Force, and Marines) with 33% minority representation. Inclusion criteria were current PTSD and/or SUD. Ten clinicians participated in this study after receiving SS training. Results showed significant improvements on most outcomes, including substance use on the Brief Addiction Monitor; PTSD symptoms on the PTSD Checklist-Military Version (total and criterion D); and the Trauma Symptom Checklist-40 (sexual abuse trauma index and anxiety subscale); functioning on the Sheehan Disability Scale (total and family subscale); psychopathology on the Zung Depression Scale total; the Behavior and Symptom Identification Scale (BASIS)-24 (total and subscales depression functioning, emotional liability, and psychosis); and the Brief Symptom Inventory-18 (total and anxiety subscale); and coping on the Coping Self-Efficacy Scale (total). Satisfaction was strong. Discussion includes methodology limitations and next steps.

Centering prayer’s effects on psycho-spiritual outcomes: a pilot outcome study

ABSTRACTCentering prayer is a spiritual and religious form of meditation grounded in the history of Christian contemplative prayer. Despite its popularity, empirical research investigating centering prayer’s effects on psycho-spiritual outcomes is relative sparse. This pilot outcome study explored the effect of a centering prayer workshop on participants’ (N = 9) depression, anxiety, stress, spiritual transcendence, religious crisis, faith development, and mindfulness. Several significant changes were noted over the course of the six-week study, including decreased anxiety and stress, and increased faith development and mindfulness. Interestingly, we noted that participants likely also experienced a spiritual or religious struggle that follows the established spiritual development paradigm called the Dark Night of the Soul. The study did not include a control group, and so did not account for effects related to history, maturation, or regression to the mean. Nevertheless, the initial results prove promising to develop more sophisticated research programmes that replicate the study’s findings.

Peer-Led Seeking Safety: Results of a Pilot Outcome Study with Relevance to Public Health

There is a rich history of peer-led recovery efforts related to substance use disorder (SUD). Yet we know of no peer-led approaches for co-occurring SUD and trauma-related problems. This combination is widespread, has impact on multiple life domains, and presents major recovery challenges. In this pilot, we evaluated peer-led Seeking Safety (SS). SS is the most evidence-based and widely implemented therapy for SUD with co-occurring PTSD or other trauma-related problems. Eighteen women in residential substance-abuse treatment participated. All met SUD criteria (primarily opiate and cocaine dependence); most had a comorbid mental health disorder; and they had elevated trauma-related symptoms. The 25 SS topics were conducted twice-weekly. Participants were assessed at baseline and end-of-treatment, with some measures also collected monthly. Results showed significant positive outcomes in trauma-related problems (the Trauma Symptom Checklist-40); psychopathology (the Brief Symptom Inventory); functioning (the BASIS-32, including impulsive-addictive behavior); self-compassion (the Self-Compassion Scale); and SS coping skills. Effect sizes were consistently large. SS satisfaction and fidelity ratings were high. Substance use levels could not be assessed due to the residential setting. Qualitative data indicated enthusiasm for peer-SS by both peers and staff. Study limitations, future research, and public health relevance are discussed.

Seeking Safety Therapy for Pathological Gambling and PTSD: A Pilot Outcome Study

This pilot study evaluated Seeking Safety (SS) therapy for seven outpatients with current comorbid pathological gambling (PG) and posttraumatic stress disorder (PTSD). This represents the first treatment outcome study of this population, and included both genders and 29% minorities. We found significant improvements in: PTSD/trauma (the PTSD Checklist criterion B symptoms; the Trauma Symptom Inventory overall mean and subscales anxiety, dissociation, sexual abuse trauma index, sex problems; and the World Assumptions Scale benevolence subscale); gambling (the Gamblers Beliefs Questionnaire overall mean and subscales illusion of control); functioning (the Basis-32 overall mean and depression/anxiety subscale); psychopathology (the Brief Symptom Inventory overall mean and subscales anxiety and depression; and the Addiction Severity Index, ASI, psychiatric composite score); self-compassion (the Self-Compassion Scale overall mean and subscales isolation, overidentified, and self-judgment); and helping alliance (the Helping Alliance Questionnaire overall mean). One variable indicated worsening (employment composite subscale on the ASI), possibly reflecting measurement issues. SS attendance was excellent. PTSD onset occurred prior to PG onset for most of the sample, and most believed the two disorders were related. Overall, we found that SS can be effectively conducted for comorbid PTSD and PG, with improvements in numerous domains and high acceptability. Limitations are discussed.

A Controlled Pilot-Outcome Study of Sensory Integration (SI) in the Treatment of Complex Adaptation to Traumatic Stress

This study tested whether sensory integration (SI) treatment combined with psychotherapy would improve symptom outcome over psychotherapy alone in the treatment of complex posttraumatic stress, as measured by the Disorders of Extreme Stress Not Otherwise Specified (DESNOS) clinical construct in a group of 10 adult patients with histories of childhood abuse. DESNOS symptoms were assessed at three time periods (T1, baseline; T2, after experimental group SI treatment; and T3, after wait-list control group SI treatment) using the Structured Interview for Disorders of Extreme Stress (SIDES). The Sensory Learning Program™ (SLP), developed by the Sensory Learning Institute of Boulder, Colorado, was used as the SI treatment modality. Results indicated significant differential improvement for the group treated with SLP in SIDES Total Score (T1/T2 and T2/T3), Self Perception (T1/T2 and T2/T3), Affect Regulation (T2/T3), and Alterations in Meaning (T1/T2).

Comparison of Brief Group Interventions to Promote Forgiveness: A Pilot Outcome Study

Helping clients come to terms with past hurts such as sexual, physical, or verbal abuse is often an important goal of therapy. Research suggests that specific treatments to help people forgive their offenders can be effective. However, these treatments have not been systematically compared with other treatments that are typically offered in real-world settings. The aim of this study was to compare a group-based explicit forgiveness intervention with process-oriented group therapy. Analyses indicated that both group formats were more effective than no treatment, resulting in less revenge, less negative reactions toward the offender, and fewer psychological symptoms. The two treatments did not differ from each other on any of the outcome variables.

A New Gender-Based Model for Women's Recovery From Substance Abuse: Results of a Pilot Outcome Study

Despite repeated calls for gender-based recovery models for women, there has been a lack of empirical research on this topic. We thus sought to evaluate a women's manual-based substance use disorder recovery model in a pilot study. Participants were opioid-dependent women in a methadone maintenance treatment program who received 12 sessions of the gender-based model in group format over two months. Assessment was conducted before and after the intervention, with results indicating significant improvements in drug use (verified by urinalysis), impulsive-addictive behavior, global improvement, and knowledge of the treatment concepts. Patients' high attendance rate (87% of available sessions) and strong treatment satisfaction additionally support the potential use of this treatment model. Future research would benefit from larger samples and enhanced scientific methodology.

Australasian dialectical behaviour therapy pilot outcome study: effectiveness, utility and feasibility

Australasian dialectical behaviour therapy pilot outcome study: effectiveness, utility and feasibility

Australasian Dialectical Behaviour Therapy Pilot Outcome Study: Effectiveness, Utility and Feasibility

This paper aims to describe the outcome of 10 patients treated in a New Zealand pilot study of dialectical behaviour therapy (DBT) for people with borderline personality disorder (BPD), and to ascertain the clinical utility and feasibility of implementing DBT into a standard New Zealand public mental health service. Patients had a clinical and an International Personality Disorder Examination diagnosis of BPD and received 6 months of standard DBT treatment. Rating scales used were the Millon Clinical Muliaxial Inventory, 3rd edition (MCMI-III) and the Symptom Checklist 90-Revised (SCL-90-R), which were completed pre treatment and post treatment. Pre-post treatment data were completed on inpatient resource usage. Qualitative patient interviews were conducted post treatment. There were statistically significant improvements in functioning on 10 of the 24 MCMI-III subscales (p < 0.03 to p < 0.0008), including notably the borderline personality subscale (p < 0.01) and the anxiety (p < 0.05) and depression (p < 0.001) subscales. There was a statistically significant improvement on the Global Severity Index of the SCL-90-R (p < 0.001) and on 10 of the 12 SCL-90-R scales (p < 0.05 to p < 0.001). The hospital bed days used decreased from 0.57 days per patient per month to 0.2 days per patient per month. These preliminary results document the clinical effectiveness of DBT. Dialectical behaviour therapy has practical and clinical utility of relevance to Australasian public mental health services. A DBT service can be successfully implemented within existing public mental health services.

Spiritually-focused psychotherapy for people diagnosed with cancer: A pilot outcome study

This study compared the efficacy of spiritually-focused therapy (SFT) (n = 9) for people diagnosed with cancer to a no-treatment control condition (NTC) (n = 7). Physical well-being (symptoms, treatment side effects, pain frequency and severity, and physical functioning) and psychological well-being (depression and anxiety) were assessed at pre-treatment, post-treatment, and two-month follow-up. Spiritual and religious coping were assessed at baseline. At baseline, surrendering control to God and positive religious coping were associated with less depression and pain severity. Positive religious coping was also associated with less anxiety and greater physical well-being. Negative religious coping was correlated with greater depression, anxiety, pain frequency and severity, and poorer overall physical well-being. In terms of the intervention, both depression and pain severity remained relatively stable across time for the SFT group but increased for the NTC condition.

Homeopathic treatment of hot flushes: a pilot study

Hot flushes are a common problem, especially for menopausal women for whom hormone replacement therapy (HRT) is contra-indicated or who prefer not to take it and patients receiving Tamoxifen. Some seek homeopathic treatment.We report an uncontrolled, pilot outcome study, conducted at the Tunbridge Wells Homeopathic Hospital (TWHH) in 1998–1999. The study was conducted in out-patient consultations booked in the usual way. Thirty-one patients referred to the Department for menopausal flushes and seen for an initial consultation and at least one follow-up review, were assessed in three groups:•Hot flushes: No history of carcinoma of the breast.•Hot flushes: Treatment for breast carcinoma, not receiving Tamoxifen.•Hot flushes: Treatment for breast cancer including Tamoxifen.For all patients, the initial and follow-up assessments included review of hot flush frequency and severity. Patients also completed their own self-assessment rating after follow-up consultations.The results indicate useful symptomatic benefit for all three groups of patients.

Intradiscal Electrothermal Therapy: A Preliminary Report

Internal disc disruption is a common cause of disabling low back pain in a substantial number of young, healthy adults. A clinical diagnosis of internal disruption, in absence of objective clinical findings, is convincingly established only by means of provocation discography. Intradiscal electrothermal therapy has been shown to be effective in managing chronic disabling discogenic pain. This prospective pilot outcome study was designed to investigate the effectiveness of intradiscal electrothermal annuloplasty in a series of patients with chronic functionally disabling discogenic low back pain. The results showed greater than 50% pain relief in 67% of the patients. In addition, a significant decrease in visual analog pain scores was also seen. Further, the assessment of functional status showed significant improvement with standing and walking, whereas sitting also demonstrated significant improvement in 62% of the patients, though it was not statistically significant. No complications were noted in the perioperative period or during the follow-up period. In conclusion, intradiscal electrothermal therapy is a safe and effective procedure in patients suffering with chronic functionally limiting discogenic pain who fail to respond to aggressive conservative modalities of treatments as well as interventional therapy with injections.

Intradiscal Electrothermal Annuloplasty (IDET): A Novel Approach for Treating Chronic Discogenic Back Pain

Objective. This one-year pilot outcome study was designed to investigate prospectively a series of patients with chronic discogenic back pain who underwent intradiscal electrothermal annuloplasty (IDET). Patients with chronic discogenic low back pain usually respond poorly to conservative medical care. Spinal fusion procedures have yielded mixed results. IDET is a new procedure to heat the intervertebral disc for the purpose of relieving discogenic pain. This study presents the one-year results for the first 32 patients undergoing the IDET procedure. The objective of this article is to determine the safety and efficacy of the IDET procedure in patients with chronic discogenic back pain. Methods. Utilizing standard discographic technique, the disc was heated using a navigable intradiscal catheter with a temperature-controlled thermal resistive coil. Six-month and one-year outcomes were assessed comparatively within subjects using a Roland-Morris (RM) questionnaire and a Visual Analog Scale (VAS), and between subjects using the NASS Low Back Pain Outcome Assessment Instrument Satisfaction Index and a general activity scale modified from the back pain/disability scale from the same instrument. The results from the individual outcome measures were combined to generate an overall outcome of favorable, nonfavorable, and no change. Results. There were no significant differences between overall outcome measures at 6-month and 12-month follow-ups. At 12 month follow-up the VAS had a mean decrease of 1.84 (sd = 2.38) and the RM had a mean decrease of 4.03 (sd = 4.82). 78.1% of patients stated that the procedure met their expectations or that they would undergo the same treatment for the same outcome. 53.1% of patients stated that their overall activity level was either better or much better compared to before the procedure. Overall, 62.5% had a favorable outcome, 12.5% nonfavorable, and 25% no change. Patients with excellent or good catheter positions and those with low pressure sensitive discs on preoperative discography had the most favorable outcomes. There were no significant complications. Conclusions. One-year pilot study outcome results suggest that IDET may be an effective, minimally invasive treatment for chronic discogenic low back pain.

An outcome study of psychotherapy for patients with borderline personality disorder.

This study evaluated the effectiveness of well-defined outpatient psychotherapy for patients with borderline personality disorder. Thirty patients with borderline personality disorder diagnosed according to the DSM-III criteria were given twice weekly outpatient psychotherapy for 12 months by trainee therapists who were closely supervised. The treatment approach was based on a psychology of self (this term being used in its broad sense), and strong efforts were made to ensure that all therapists adhered to the treatment model. Outcome measures included frequency of use of drugs (both prescribed and illegal), number of visits to medical professionals, number of episodes of violence and self-harm, time away from work, number of hospital admissions, time spent as an inpatient, score on a self-report index of symptoms, and number of DSM-III criteria (weighted for frequency, severity, and duration) fulfilled. The subjects showed statistically significant improvement from the initial assessment to the end of the year of follow-up on every measure. Moreover, 30% of the subjects no longer fulfilled the DSM-III criteria for borderline personality disorder. This improvement had persisted 1 year after the cessation of therapy. The results suggest that a specific form of psychotherapy is of benefit for patients with borderline personality disorder.