Learning to manage stress is an important lifestyle change for participants in cardiac rehabilitation programs. Progressive muscle relaxation (PMR) is one stress management approach that has produced positive benefits among different patient populations. The purpose of this study was to identify the effects of learning and practicing PMR in a population of cardiac rehabilitation patients. Blood pressure and heart rate data, and scores on the Spielberger State-Trait Anxiety Inventory (STAI) were collected from a treatment group and a control group of patients enrolled in phases II and III of cardiac rehabilitation. Analysis of the data revealed positive effects of PMR on the variables heart rate and state of anxiety. In addition, written evaluations of PMR from patients in the treatment group indicated a high degree of subjective satisfaction with PMR as a means to reduce stress in their lives.
The incidence of falls among elderly patients has been and continues to be a major challenge for nurses. Falls add physical injury and mental stress to patients' existing health problems, are a deterrent to rehabilitation, and increase healthcare costs. This study describes the variables that nurses identify as influencing their clinical decision making and the nursing behaviors associated with preventing patient falls. The study was grounded in the theory that discretionary nursing behaviors are related to nursing expertise, and the study was guided by the assumption that such behaviors are proactive and anticipatory. An analysis of interviews of registered nurses (n = 14) working on a geriatric rehabilitation unit in a medical center in Ohio focused on the zones of association and the contextual meanings of language used by the nurses when discussing patient falls. Four themes emerged: the reasons for patient falls, identifying patients who are likely to fall, preventing falls, and nurses' feelings when patients fall.
Over the past few decades, increasing evidence has shown the beneficial effects of humor. The use of caregiver-initiated humor as an intervention in healthcare settings has both physiological and emotional benefits. Little has been written, however, about another very important aspect of humor, patient-initiated humor. When patients use humor to relieve their feelings of stress, uncertainty, or embarrassment, they are trying to communicate with their caregiver. This use of humor by patients is not to "make light" of the situation, but rather a way to reduce their feelings of dehumanization. Humor is an interactive process of sharing and an important aspect of communication. Patients will observe the caregiver for a response. An open, accepting response signals understanding; a negative or null response, however, may serve to isolate the patient. The guidelines discussed in this article for recognizing, interpreting, and responding to patient-initiated humor will help home care and hospice nurses to foster increased open patient/caregiver communication and create a supportive humanistic atmosphere for patient care.
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