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Individuals with diabetic peripheral neuropathy were unable to use a "new" strategy gait pattern to reduce peak plantar pressures long term (1 week). The use of visual feedback following the trial did not assist in the learning of a new walking pattern.

Substance abuse affects African American women at an increasingly alarming rate. The interaction of substance abuse and traumatic events requires exploration. For many African American women, early life trauma plays a critical role in how and when they fall victim to the ravages of substance abuse. This article about a phenomenological study of 15 African American women uses intense narratives to disclose experiences of incest, rape, abuse, and other horrors that led to drug and alcohol use to extinguish pain. The themes include family history of substance abuse, lack of a caring childhood environment, pain resulting from trauma, and coping and recovery. The womens' stories provide insights for nurses in practice and research related to the psychosocial health of women.

The use of seclusion or seclusion and restraints (S/SR) may affect patients negatively, even if controlling their behavior in the short run, by placing them in the "victim" role and fostering a corrosive atmosphere of patient-caregiver mistrust and alienation. This project's goal was to reduce the use of the most restrictive measures by increasing the use of the less restrictive removal from stimuli (RFS). Verbally and even physically threatening patients in a psychiatric intensive care unit were removed from stimuli if their behaviors were not sustained and they ultimately cooperated with staff. RFS was deemed successful when a patient did not need more restrictive measures following its use. The data for this study were obtained by tabulating RFS and S/SR utilization rates for a year. Frequencies, measures of variance, ratios, and t ratios were used to analyze the data. The use of RFS and other nonrestrictive measures to reduce patient stress and frustration resulted in decreased utilization of seclusion and restraints. The frequency and severity of negativistic, aggressive behaviors of patients were also observed to have diminished.

Background Little is known about illness-related uncertainty and decreased health-related quality of life in patients undergoing initial coronary angiography or about the long-term effects of uncertainty. Objectives To compare patients with and without high levels of uncertainty before angiography and to examine the influence of uncertainty on health-related quality of life 1 year after angiography. Methods In a prospective, longitudinal study, measurements of perceived control, uncertainty, affective distress, and health-related quality of life were collected from 93 patients before angiography (baseline) and 1 year later. At baseline, patients were classified into high- and low-uncertainty groups by median split. At 1 year, analysis of variance was used to compare health-related quality of life and psychological outcomes in the 2 groups, and multiple linear regression with stepwise entry was used to identify independent determinants of health-related quality of life. Results Compared with patients with low baseline uncertainty, patients with high baseline uncertainty had higher levels of anxiety and depression and lower levels of perceived control and health-related quality of life 1 year after angiography. Baseline health-related quality of life, uncertainty, and life stress accounted for 54% of the variance in health-related quality of life, even when angiographic outcome was controlled for (P < .001). Baseline uncertainty was independently associated with health-related quality of life (β = −0.25; 95% confidence interval, −9.40 to −0.05; P = .02). Conclusions At initial angiography, high levels of uncertainty about illness portend negative health-related quality of life outcomes up to 1 year later.