Using the Internet for Qualitative Research in Nursing

The nature of qualitative research lends itself to the use of the Internet for a variety of reasons. The Internet can be used for recruitment and provide immediate feedback from participants, either through online interviewing, or open ended questionnaires. Interviews may be conducted online with a set list of guiding questions, and follow up can be accomplished with email communication. If information is received in digital form, there is no need for labor intensive transcription that qualitative research often involves

Privacy Issues with the Electronic Medical Record

Electronic medical records (EMR) all have privacy safeguards in place. Major healthcare institutions have taken steps to prevent employees from looking up information on patients whom they do not treat directly, however numerous potential intrusions into patient privacy are still possible. Centralization of medical records in the increasing number of multi-group practices distributes personal medical data over larger networks and increases the likelihood that personal medical data may be shared or viewed by unauthorized users. This article reviews the benefits of EMRs and the possible mechanisms by which data may be shared without patient knowledge, as well as solutions and safeguards that need to be taken to protect the privacy of patient medical records

The Lived Experience of College Sudents Who have Been Medicated with Antidepressants

Increasingly in the last two decades college students have been diagnosed with depression, with estimates of major depression higher than the general population (American Psychiatric Association {APA}, 2005). According to the literature, the stresses of college life along with increased rates of substance abuse, and binge drinking have contributed to the rise in depression in this population. In a large survey of American college students, over half reported some depression since entering college (National Center on Addiction and Substance Abuse {NCASA}, 2003). Correspondingly, the percentage of young people treated with antidepressants has grown over the past decade, and there is concern that for younger individuals the newer antidepressants may increase suicidal ideation (Simon, 2006). Suicide is the second leading cause of death among college students, and although people between the ages of 20 and 24 who are not in college are more likely to commit suicide, one study found that 10% of college students interviewed had considered suicide within the past year (NCASA, 2003). Although numerous studies have been completed (Wagner, Ambrosini, Rynn, Wohlberg, Yang, Greenberg et al., 2003; Keller, Ryna, Strober, Klein, Kutcher & Birmaher et al., 2001) to determine the appropriate use of antidepressants in depression, there have been few qualitative studies available that actually explore the experiences of young people being medicated with antidepressants (Fornos, Mika, Bayles, Serrano, Jimenez & Villarreal, 2005; Simon, 2006; Dundon, 2006). The purpose of this descriptive exploratory study was to explore how college students perceive the experience of having been medicated with antidepressants. A review of the literature related to depression and college students, the causes of stress in students‟ lives, non-medical treatment of depression, plus information on the SSRI antidepressants is presented. The study describes the lived experience of college students prescribed antidepressants utilizing phenomenology as its philosophical basis. The internet was used to obtain informed consent, and conduct qualitative interviews to gather information on students‟ lived experience. These interviews explored the students‟ experiences with being medicated for depression with antidepressants, and their experiences with stress, anxiety and depression in college. In presenting the findings, whenever possible the students own words were used to describe their experiences with antidepressants. The main findings of the this qualitative study included a feeling of numbness in students who were on antidepressants, a general dislike for the medication, even if they felt it was initially useful. It also presents a picture of the academic, familial and financial stresses college students are under as well as alternate ways they deal with depression and stress. Exercise, music and marijuana were seen as great stress relievers, and talking to good friends very helpful for overcoming depression. The students advised others to carefully do their research before they decide to start on an antidepressant medication. Implications for nursing and the role of Nurse practitioners in making decisions about medicating depressed college students are discussed

The Importance of Screening for Sleep Apnea in the Heart Failure Population

Background: Sleep disordered breathing occurs in over half of the estimated 5.1 million people in the United States diagnosed with heart failure. Aim and Methods: The purpose of this integrative review is to find evidence for the routine use of a sleep apnea screening protocol in patients with heart failure. Results: Several useful tools are described including the Epworth Sleepiness Scale, the STOP BANG questionnaire and the Berlin questionnaire. Using one of these tools along with an overnight pulse oximetry is a cost effective way to screen patients before the more costly sleep studies. Conclusions: Evidence shows that treatment of sleep apnea in this population decreases not only morbidity and mortality rates, but the overall cost burden of the disease as well

Bendectin and birth defects II: Ecological analyses

BACKGROUND Bendectin was the primary pharmaceutical treatment of nausea and vomiting of pregnancy (NVP) in the United States until the early 1980s. Its manufacture was then discontinued after public allegations that it was causing birth defects. Subsequently, meta-analyses of the many epidemiological cohort and case/control studies used to examine that hypothesis have demonstrated the absence of a detectable teratogenic effect. This study presents an ecological analysis of the same hypothesis that examines specific malformations. METHODS Annual birth defect prevalence data for the 1970s to the 1990s have been obtained for specific birth defects from the Center for Disease Control's nationwide Birth Defect Monitoring Program. These data for the US have been compared graphically to the annual US Bendectin sales for the treatment of NVP. Data have also been obtained for annual US rates for hospitalization for NVP. The three data sets have been temporally compared in graphic analysis. RESULTS The temporal trends in prevalence rates for specific birth defects examined from 1970 through 1992 did not show changes that reflected the cessation of Bendectin use over the 1980–84 period. Further, the NVP hospitalization rate doubled when Bendectin use ceased. CONCLUSIONS The population results of the ecological analyses complement the person-specific results of the epidemiological analyses in finding no evidence of a teratogenic effect from the use of Bendectin. Birth Defects Research (Part A) 67:88–97, 2003. © 2003 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/35295/1/10034_ftp.pd

The lived experience of college students who have been medicated with antidepressants

Increasingly in the last two decades college students have been diagnosed with depression, with estimates of major depression higher than the general population (American Psychiatric Association {APA}, 2005). According to the literature, the stresses of college life along with increased rates of substance abuse, and binge drinking have contributed to the rise in depression in this population. In a large survey of American college students, over half reported some depression since entering college (National Center on Addiction and Substance Abuse {NCASA}, 2003). Correspondingly, the percentage of young people treated with antidepressants has grown over the past decade, and there is concern that for younger individuals the newer antidepressants may increase suicidal ideation (Simon, 2006). Suicide is the second leading cause of death among college students, and although people between the ages of 20 and 24 who are not in college are more likely to commit suicide, one study found that 10% of college students interviewed had considered suicide within the past year (NCASA, 2003). Although numerous studies have been completed (Wagner, Ambrosini, Rynn, Wohlberg, Yang, Greenberg et al., 2003; Keller, Ryna, Strober, Klein, Kutcher & Birmaher et al., 2001) to determine the appropriate use of antidepressants in depression, there have been few qualitative studies available that actually explore the experiences of young people being medicated with antidepressants (Fornos, Mika, Bayles, Serrano, Jimenez & Villarreal, 2005; Simon, 2006; Dundon, 2006). The purpose of this descriptive exploratory study was to explore how college students perceive the experience of having been medicated with antidepressants. A review of the literature related to depression and college students, the causes of stress in students\u27 lives, non-medical treatment of depression, plus information on the SSRI antidepressants is presented. The study describes the lived experience of college students prescribed antidepressants utilizing phenomenology as its philosophical basis. The internet was used to obtain informed consent, and conduct qualitative interviews to gather information on students\u27 lived experience. These interviews explored the students\u27 experiences with being medicated for depression with antidepressants, and their experiences with stress, anxiety and depression in college. In presenting the findings, whenever possible the students own words were used to describe their experiences with antidepressants. The main findings of the this qualitative study included a feeling of numbness in students who were on antidepressants, a general dislike for the medication, even if they felt it was initially useful. It also presents a picture of the academic, familial and financial stresses college students are under as well as alternate ways they deal with depression and stress. Exercise, music and marijuana were seen as great stress relievers, and talking to good friends very helpful for overcoming depression. The students advised others to carefully do their research before they decide to start on an antidepressant medication. Implications for nursing and the role of Nurse practitioners in making decisions about medicating depressed college students are discussed