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Author |
Horsburgh, M. |
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Title |
Graduate nurses' adjustment to initial employment |
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Year |
1987 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
University of Auckland, Auckland Institute of Te |
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Volume |
14 |
Issue |
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Pages  |
610-617 |
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Abstract |
An ethnographic study which attempts to understand what initial employment means to graduates from a comprehensive nursing course. The researcher participated in the first 3-4 months of the nurses' employment in general hospital settings. Five major themes emerge from the study indicating that the rhetoric practice of the school of nursing is different from the rhetoric and practice within general hospital settings. The reality of initial employment for the new graduated conflicts with the values and ideals of nursing promulgated by the comprehensive nursing course. The educational program stressed patient centred nursing, where nurses accepted responsibility for the continuing care of individuals. In contrast the hospital settings stress nursing as management of tasks across different patients. This conflict was a major source of frustration for the 'beginning' nurses. Ultimately they accept the reality of nursing as the management of tasks, but not without some personal cost. Orientation programs and the early employment period focus on 'fitting in to the system'. A significant determinant of the practice of new graduates are context effects such the time of their shift and the availability of experienced nurses. A number of management practices foster and maintain a beginning level of practice and new graduates have no opportunity to practice as autonomous nurses within a multi disciplinary health care team. Beginning practice is identified in new graduates through their difficulties in coping with unplanned or unexpected events. The initial employment period is dominated by shift work, resulting tiredness and adjustment to social activities.It is argued that management practices which support the ideals of comprehensive nursing courses and totally qualified nursing workforce have yet to occur. There are implications in this study for nursing education and nursing practice |
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Call Number |
NRSNZNO @ research @ 59 |
Serial |
59 |
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Author |
Dodd, J.E.L. |
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Title |
Nursing evaluation of the efficacy of analgesic delivery in post operative pain |
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Year |
1986 |
Publication |
Australian Clinical Review |
Abbreviated Journal |
Auckland Hospital Library |
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Volume |
6 |
Issue |
23 |
Pages |
206-212 |
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Abstract |
The progress of 22 adult patients was recorded for three days post operatively. Pain was assessed at rest and on activity three times a day using visual analogues. Nausea levels were assessed similarly. All analgesics and anti emetics administered were recorded. There was a wide range of variation in the administration of medications and consequently a wide range of effectiveness. A significant proportion of patients showed unacceptably high levels of pain indicating under treatment. Patients and nurses had conflicting expectations of who should initiate the request for pain medication |
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Call Number |
NRSNZNO @ research @ 85 |
Serial |
85 |
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Author |
Butler, A.M. |
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Title |
Towards a staffing formula: home visit rating scales for community health nurses |
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Year |
1980 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
Auckland Hospital |
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Volume |
73 |
Issue |
9 |
Pages |
9-14 |
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Abstract |
Reports the development of a set of Rating scales which can be used to measure the Home visiting part of the workload of Community Health Nurses. The scales provide a useful tool for the equitable distribution of Home visits among existing staff and can assist in the assessment of the total workload of the Community Health Nurses |
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Call Number |
NRSNZNO @ research @ 138 |
Serial |
138 |
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Author |
Perry, J.(see also C.) |
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Title |
Currents – towards professionalism |
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Year |
1990 |
Publication |
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Abbreviated Journal |
Auckland Institute of Technology Library, NZNO Li |
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Pages |
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Abstract |
Attitudes towards the concept of professionalism have not been explored to any great extent in this country, especially the attitudes of the Clinical Nurse practitioner. The importance of knowing what Nurses attitudes are to this concept is central to the recognition of the current developmental stage and growth of the profession. A twenty statement Like-style attitudinal questionnaire was given to Registered Nurses to measure current attitudes to professionalism. No statistical significance was found between the degree of positively to professionalism and years of service, educational qualifications eg, practise area, or involvement with a professional organisation. There appeared to be a positive relationship between questionnaire score and length of time in the current practise area ( the longer the service the higher the score). Further statistical significance was found in questions highlighting what Nurses think of Nursing as a profession. This study should form the basis of further research and provide some thought for Nurse leaders, educators and policy makers |
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Call Number |
NRSNZNO @ research @ 42 |
Serial |
42 |
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Author |
Shadbolt, Y.T. |
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Title |
Curriculum innovation in a school of nursing – a case study |
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Year |
1984 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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The study gives an account of curriculum development and innovation in a New Zealand school of nursing and focuses on some aspects of the basic diploma course. The study attempts, through the medium of case study, to illuminate the way in which significant curriculum decisions are made and ideas translated into institutional and technical form. Evidence is derived from the recorded perceptions of the participants, observations, and analyses of documented material. The findings confirm that the field of study is complex, multivariable and dynamic, and that translation of the curriculum on paper involves a multitude of deliberative and factual decisions by practicing teachers |
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Call Number |
NRSNZNO @ research @ 43 |
Serial |
43 |
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Author |
Butler, A.M. |
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Title |
Development of patient dependency rating scales for use in psychiatric hosptials |
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Year |
1976 |
Publication |
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Abbreviated Journal |
Auckland Hospital Board |
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Call Number |
NRSNZNO @ research @ 47 |
Serial |
47 |
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Author |
Butler, A.M. |
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Title |
Nursing care: an exploratory study |
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Year |
1977 |
Publication |
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Abbreviated Journal |
Auckland University Library |
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Abstract |
A study of role discrepancy or role conflict experienced by Registered Nurses in a Hospital setting |
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Call Number |
NRSNZNO @ research @ 80 |
Serial |
80 |
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Author |
Jones, M. |
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Title |
The complexities of post operative pain management and a study of the effectiveness of continuous intravenous narcotic infusion pumps as a means of pain relief in the first 48 hours post operatively |
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Year |
1985 |
Publication |
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Abbreviated Journal |
Author, Auckland Hospital, Auckland Institute of |
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Abstract |
The purpose of this paper was to observe the effectiveness of continuous intravenous narcotic infusions as a means of pain relief in the first 48 hours post operatively. 12 patients who had experienced major thoracic or abdominal surgery participated in the study. Pain was assessed at rest and on activity on visual analogues at 5 specific times daily for up to 48 hours post operatively. Data was also collected from a structured interview within the first 48 hours and a retrospective interview when the infusion was discontinued. Results indicated- 1. Very little correlation of changes in pain relief dose to the assessment of pain intensity. 2. Documentation and assessment was not always thoroughly completed. 3. Inadequate treatment of pain post operatively was evident especially on activity. It should be emphasised that pain management could be improved through a focus in interdisciplinary consultation, continuing in service education on pain management and accountability in procedure. |
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Call Number |
NRSNZNO @ research @ 102 |
Serial |
102 |
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Author |
Miller, N.R. |
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Title |
The problems experienced by graduates of student based comprehensive nursing programs as they provide nursing care in general hospitals |
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Year |
1978 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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Issue |
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Pages |
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Abstract |
When professionals are employed in bureaucratic organisations they can expect to experience incongruence between their professional role conception and the bureaucratic demands of the organisation which lead to their experiencing role deprivation. Students of comprehensive Nursing programs during their preparation are socialised into a role consistent with their professional group when employed in Hospitals, are subjected to its bureaucratic administrative structure This study examines problems experienced by graduates of these programs, the way they cope with these problems and the extent of their role deprivation, 6 months after commencing employment in General hospitals. The result obtained by questionnaire and interview indicate the main problems are related to the provision of nursing Care, the organisation of Hospital and Communication. These problems prevent graduates from functioning as professional Nurses. Almost half considered they have been successful in resolving them. All graduates experienced a considerable magnitude of role deprivation. there are implications both for agencies and for those preparing Comprehensive Nurses |
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Call Number |
NRSNZNO @ research @ 120 |
Serial |
120 |
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Author |
Williams, H.; Cuthbertson, S.; Newby, L.; Streat, S.J. |
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Title |
A follow-up service improves bereavement care in an intensive care unit |
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Year |
1998 |
Publication |
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Abbreviated Journal |
Auckland Hospital Library |
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Call Number |
NRSNZNO @ research @ 149 |
Serial |
149 |
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Author |
Margetts, M.; Cuthbertson, S.; Streat, S.J. |
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Title |
Bereavement follow-up service after fatal critical illness |
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Year |
1995 |
Publication |
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Abbreviated Journal |
DCCM, Auckland Hospital |
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Fatal illness is often short. Communication between patient and family is impaired and how to best meet family needs is unclear. We began a follow-up service to determine current next-of-kins outcomes and remedy service deficiencies. A critical care nurse identified deaths from our data base and completed a structured telephone interview with the next-of-kin. There were 374 admissions from 1/1/95 – 17/5/95, 55 died. Next- of-kin of 52 patients (M29, age 19-88 median 52) were contactable 16-70 (median 33)days later. All (defacto/wives 18, husbands 9, mothers 9, daughters 8, others 8) consented to interview (5 -80, median 15 minutes). Forty-nine had resumed normal home activities and 23/25 workers had returned to work. Thirty-three still had disturbed sleep, three were taking hypnotics. Twenty-four had had contact with their general practitioner because of the death (six were prescribed sedatives or hypnotics). Nineteen had financial problems. Forty-seven described DCCM care positively, 35 specifically (nursing care and compassion 15, communication 8, flexible visitors policy8) but 13 had particular difficulties (communication 4 , waiting 2, facilities 4) and 4 serious non-DCCM issues. Forty-six considered themselves well informed and understood well the sequence of events. Forty-eight identified family and friends as primary support. Three requested information about another agency (counseling), 9 asked us to contact as further relative. A telephone bereavement service is well received by next-of-kin. Most families members resolve their early grief without external agencies but sleep and money are problems. We have improved our facilities and are addressing communication and cultural issues |
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Call Number |
NRSNZNO @ research @ 199 |
Serial |
199 |
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Author |
Margetts, M.; Cuthbertson, S.; Streat, S.J. |
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Title |
Bereavement follow-up – its impact on practice |
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Year |
1996 |
Publication |
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Abbreviated Journal |
DCCM Auckland Hospital |
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Since 1995 we have provided a bereavement follow-up service but the benefits of this to clinical care have not previously been reported . We reviewed the 1995 results, documentation methods, system design, discussed with reviewers their data collection, interview process and its effect on them and their practice. Next-of-kin of only 99/151 patients ( M87 age 14-88) were contacted 16-149 median 34 days after the death. Sleep disturbance (55/99) were the most common problems. We now give next-of- kin literature including a pamphlet which introduces our service and discusses these problems. Most next-of-kin (77/99) commented favorably on DCCM care, but 16/99 identified inadequate facilities and communication problems as service deficiencies. We have improved facilities (paint, furniture, telephone, drinks machine). We now notify patients general practitioners of every death and bring families back for meetings with staff when necessary. We changed systems of case identification and recording of next-of-kin information. Nurse interviewers (8) identified their needs for improved telephone skills, education about grief and research, debriefing after calls and their need for acknowledgement of participation in this service. Study days now address these issues. Interviewers difficulties with interview content have lead to changes. They suggested peer review of data forms to improve completeness which now occurs. Some found the interview process personally disturbing, but all reported positive changes in their practice with bereaved families.Within two years a bereavement service has led to improvements in facilities, communication, and staff expertise, it is now part of our holistic care |
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Call Number |
NRSNZNO @ research @ 200 |
Serial |
200 |
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Author |
Key, R.; Habashi, S.; Baber, C.; Cuthbertson, S.; Streat, S.J. |
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Title |
Long-term follow-up after Bjork flap tracheostomy |
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Year |
1994 |
Publication |
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Abbreviated Journal |
DCCM, Private Bag 92024, Auckland |
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Abstract |
Because of concern about long-term complications of bjork flap tracheostomy we followed-up 136 intensive care patients who had Bjork flap tracheotomy in 1992 a median of 117 (range 5-402) hours after intubation. Twenty died in hospital, none as a result of tracheostomy. Twenty- six patients were lost to follow-up and eleven declined. The remaining 79 had measures of health status, a quality of life questionnaire, respiratory function testing and physical examination of the neck and upper airway 9-27 months (median 14) later. Various health status measures deteriorated in 9 to 51 of 77 patients. Forty-two of 77 patients were taking prescription medication and 15/32 smokers had stopped smoking. FEV1, FVC and FEV1/FVC were significantly reduced from predicted normal (n=70, 2.8+ 1.1 vs 3.2 +0.9 p<.0001, 3.7 + 1.3 vs 4.0 + 1.0 p<.0001, 76 +11vs 79 +3 p= 0.035 respectively). Pulse oximetry was normal (>92%) in 73/74 patients tested. The median horizontal scar dimension was 45mm (range 20 to 75 mm). Nine had a median vertical scar dimension 15mm (range 8 to 25mm). Nineteen scars were hypertrophic, 56 were tethered. Two patients had already undergone tracheal scar revision at follow-up and further 13 accepted scar revision. Ten patients had abnormal voice examination, four abnormal cough, two stridor, three vocal cord lesions, three tracheal polyps and fourteen asymptomatic tracheal narrowing from 10-60% (median 25%) of the tracheal luminal diameter. Patients surviving critical illness with bjork flap tracheostomy have reduced quality of life and respiratory function and poor cosmetic result but a low incidence of important airway problems |
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Call Number |
NRSNZNO @ research @ 201 |
Serial |
201 |
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Author |
Key, R.; Cuthbertson, S.; Streat, S.J. |
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Title |
Critical care survivors follow-up service |
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Year |
1995 |
Publication |
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Abbreviated Journal |
Private Bag, 92024, Auckland |
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The extent of early remediable morbidity after critical illness is unclear. We began a follow-up service to determine outcomes, facilitate rehabilitation and remedy service deficiencies. A critical care nurse identified hospital survivors (DCCM and hospital databases), completed a structured telephone interview with the patient and intervened according to predetermined guidelines. Of 261 admission 1/1/95 29/3/95 50 died in hospital (39in DCCM). Of 211 hospital survivors (M115, age 15-84 median40) 31 could not be contacted, one died at home and 179 contacts were made 21- 120 (median 51) days after DCCM. One refused interview, 178 interviews took 8-60, (median 15) minutes. Only 68/178 had resumed normal activities and 26/78 workers had returned to work. Seventy patients had contacted general practitioners because of critical illness sequelae. One hundred patients gad 191 problems (including unhealed wounds29, pain 28, impaired mobility26, neurological deficit 178, infection 10 weight loss 9, tiredness 6 depression 5, sleep disturbance 3, others 57). Sixty-five described DCCM staff as helpful, 37 had complaints (hallucinations 6, staff behaviour5, restraints5 sedation/analgesia inadequate5 or excessive 2, poor communication3, fear3, noise 2 other 4) and 5 raised serious non-DCCM issues. Forty-four patients were called again 6-84, median 42 days later when 69/112 health problems had resolved but 29/44 patients had not resumed normal activity. Four attended a clinic and were referred to other services. A follow-up service is well received. Morbidity is common but improves within three months after critical care. We are addressing service issues |
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Call Number |
NRSNZNO @ research @ 202 |
Serial |
202 |
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Author |
Pearce, L.; Cuthbertson, S.; Streat, S.J.; Hay, D. |
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Title |
Dental hygiene in the critically ill: a randomised controlled trial of three methods |
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Year |
1996 |
Publication |
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Abbreviated Journal |
DCCM, Auckland Hospital, Private Bag 92024, Auck |
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Introduction Critically ill patients cannot clean their own teeth. A variety of methods are used but as the best method is unknown we performed a prospective randomised double-blind controlled trial of three methods.Method Of 359 consecutive admissions to the Department of Critical Care Medicine between 31/01/97 and 25/05/97, 222 were excluded (62 edentulous, 6 unexaminable, 142 transferred alive and 12 dead or dying at 24 hours). The remaining 137 patients had quantitative (picture-linked, ordinal score) assessment of caries, peridontal status and plaque (in 12 segments of teeth) before randomisation (to the use of either toothbrush, jumbo swab or sonic toothbrush) by pre-assigned sealed envelopes. All teeth were cleaned (prescribed four hourly) with 0.2% chlorhexidine solution. Daily plaque scores were obtained (by an assessor (SC) blind to treatment allocation) until withdrawal, death or transfer.Results Toothbrush Jumboswab SonicPatients assigned 50 48 39Withdrawn within 24hrs. 9 3 5Patients remaining 41 45 34Percentage of teeth segments thatare pristine: pre treatment 45 50 51 after 2 days 74 57 90 F(2.63) = 5.00 p = 0.0097 More withdrawals for patient noncompliance after randomisation occurred in the sonic group (5/34 versus 3/86). Conclusion. By the second day the sonic toothbrush was the most effective in plaque removal with the toothbrush the next most effective method |
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Call Number |
NRSNZNO @ research @ 203 |
Serial |
203 |
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