Helene Krouse - Academia.edu (original) (raw)
Papers by Helene Krouse
Otolaryngology–Head and Neck Surgery
Contemporary medical practice is grounded in rigorous scientific evidence in concert with best cl... more Contemporary medical practice is grounded in rigorous scientific evidence in concert with best clinical practices and informed shared decision making with patients. During these times of uncertainty, disruption, and even anxiety, it becomes critical that we engage with our patients and communities in thoughtful dialogue and realistic expectations regarding treatments surrounding COVID-19. The hope for a “miracle” cure and urgency to return back to normal times can stimulate irrational thought and behavior and even desperate measures by individuals or groups. It becomes especially important that we continue to use reasonable, informed clinical judgment in discussing the various options with patients.
Otolaryngology–Head and Neck Surgery
The coronavirus disease 2019 (COVID-19) pandemic has brought to light significant health inequiti... more The coronavirus disease 2019 (COVID-19) pandemic has brought to light significant health inequities that have existed in our society for decades. Blacks, Hispanics, Native Americans, and immigrants are the populations most likely to experience disparities related to burden of disease, health care, and health outcomes. Increasingly, national and state statistics on COVID-19 report disproportionately higher mortality rates in blacks. There has never been a more pressing time for us to enact progressive and far-reaching changes in social, economic, and political policies that will shape programs aimed at improving the health of all people living in the United States.
International Forum of Allergy & Rhinology
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2018
This plain language summary for patients serves as an overview in explaining hoarseness (dysphoni... more This plain language summary for patients serves as an overview in explaining hoarseness (dysphonia). The summary applies to patients in all age groups and is based on the 2018 "Clinical Practice Guideline: Hoarseness (Dysphonia) (Update)." The evidence-based guideline includes research to support more effective identification and management of patients with hoarseness (dysphonia). The primary purpose of the guideline is to improve the quality of care for patients with hoarseness (dysphonia) based on current best evidence.
Otolaryngology-Head and Neck Surgery
This plain language summary serves as an overview in explaining earwax (cerumen). The summary app... more This plain language summary serves as an overview in explaining earwax (cerumen). The summary applies to patients older than 6 months with a clinical diagnosis of earwax impaction and is based on the 2017 update of the Clinical Practice Guideline: Earwax (Cerumen Impaction). The evidence-based guideline includes research that supports diagnosis and treatment of earwax impaction. The guideline was developed to improve care by health care providers for managing earwax impaction by creating clear recommendations to use in medical practice.
Journal of the American Association of Nurse Practitioners
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2017
The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published ... more The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue of Otolaryngology-Head and Neck Surgery featuring the updated Clinical Practice Guideline: Earwax (Cerumen Impaction). To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 11 recommendations emphasize proper ear hygiene, diagnosis of cerumen impaction, factors that modify management, evaluating the need for intervention, and proper treatment. An updated guideline is needed due to new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials) and the need to add statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care.
Journal of the American Association of Nurse Practitioners, 2015
There is a niche for urgent care clinics as an alternate source of health care in the United Stat... more There is a niche for urgent care clinics as an alternate source of health care in the United States. This systematic review examines whether the use of urgent care clinics can improve access to care or if these facilities undermine continuity of primary care. Databases used were Cumulative Index for Nursing and Allied Health (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE). Articles from 2004 to 2014 were searched using keywords-access, barriers, continuity of care, nurse practitioner (NP), urgent care, retail clinic, emergency, and primary care. Urgent care clinics can improve access to care, but may also negatively impact continuity of care, preventative services, and ongoing management of chronic conditions. Barriers to primary care and benefits of urgent care are inversely related. Insufficient knowledge regarding navigation of the healthcare system, perceived urgency of medical need, and deflection of care contribute to use of urgent care over primary care. NPs are frontline healthcare providers essential to developing and maintaining successful communication and collaboration among providers across healthcare settings. In both primary care and urgent care facilities, NPs can ensure continuity of care, decreased healthcare costs, and optimized health outcomes for patients.
Clinical Drug Investigation, Feb 1, 2009
and have the potential for considerable clinical effects due to a lack of sleep and persistent da... more and have the potential for considerable clinical effects due to a lack of sleep and persistent daytime symptoms of somnolence and activity impairment. The primary objective of this investigation was to determine the effect of a 14-day course of once-daily evening administration of mometasone furoate 400 μg administered via a dry powder inhaler (MF-DPI 400 μg qd pm) on the overnight decline in pulmonary function observed in patients with nocturnal asthma. Methods: Eligible enrollees were between the ages of 18 and 60 years and had established mild to moderate asthma, with an improvement in forced expiratory volume in 1 second (FEV1) of >15% after administration of inhaled salbutamol (albuterol) 200 μg. All enrolled patients had a history of nocturnal asthma. Enrollees were randomized to receive MF-DPI 400 μg qd pm or placebo administered between 6pm and 8pm for 14 days. The primary outcome evaluated in the study was reduction in nocturnal decline in evening (8pm) to morning (6am) FEV1 values. Secondary outcomes included reduction in nocturnal decline in evening to morning peak expiratory flow rate (PEFR), polysomnographic indices of sleep, and psychometric indices (Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire [NRQLQ], 36-item Short Form of the Medical Outcomes Survey [SF-36], and Asthma Quality of Life Questionnaire [AQLQ]). Results: A total of 20 patients were randomized and completed all phases of the study. No significant differences were observed between treatment groups in the primary outcome of nocturnal decline in FEV1 from pretreatment to end of treatment. Likewise, there was no significant difference between treatment groups in polysomnographic indices of sleep or quality-of-life assessments. However,
Http Dx Doi Org 10 1080 00461528109529237, Oct 1, 2009
This article presents a comprehensive theoretical model of academic underachievement in students.... more This article presents a comprehensive theoretical model of academic underachievement in students. Past views of scholastic dysfunction have tended to focus on specific factors which psychologists have considered important, while failing to consider the problem on its broader level. The present model proposes that underachievement can be viewed as a complex interaction among three factors: (a) weaknesses in academic skills,
Nurs Res, 1982
This study examined the course and duration of the crisis inherent in the diagnosis and treatment... more This study examined the course and duration of the crisis inherent in the diagnosis and treatment of cancer in women. Three groups of female patients, breast cancer, gynecological cancer, and breast biopsy patients, were compared on the variables of depression and body image. The women were assessed prior to surgery and at one- and two-month intervals in order to determine whether their crises had been resolved within the normal six-month framework. An additional follow-up was made after 20 months to evaluate any long-term effects of the diagnosis of cancer or its treatment. Results of the study revealed that only breast biopsy and mastectomy patients adapted appropriately and were able to resolve their crises. In examining the gynecological cancer patients, initial feelings of depression and body image continued to worsen even at 20 months following surgery. Implications for nursing practice are discussed, and suggestions for future research are presented.
J Nurs Admin, 1988
Establishing a strong commitment to nursing research poses both rewards and challenges for nurse ... more Establishing a strong commitment to nursing research poses both rewards and challenges for nurse executives. The authors address the purpose and review process of the nursing research committee from the researcher's and reviewer's perspectives. A greater understanding of this process, its implications, and its benefits for nursing executives will further facilitate nursing research in the service setting.
Journal of Pediatric Nursing, 2015
Adolescence is a unique time of development incorporating a transition from child centered to adu... more Adolescence is a unique time of development incorporating a transition from child centered to adult centered health care. This transition period can be particularly challenging for individuals with a chronic disease such as asthma. Inadequate transition planning during adolescence may place an already vulnerable population such as African American adolescents with known health disparities in asthma prevalence, morbidity and mortality at risk for a continuation of poor health outcomes across the lifespan. Central to transition planning for these youth is the core element of developing and prioritizing goals. The purpose of this qualitative study was to explore the asthma self-management goals, beliefs and behaviors of urban African American adolescents prior to transitioning from pediatric to adult health care. A focus group composed of 13 African American adolescents with asthma ages 14-18years from an urban population was conducted. Responses from transcripts and field notes were reviewed using an iterative process to best characterize asthma self-management goals and beliefs that emerged. Four core themes were identified: 1) medication self-management, 2) social support, 3) independence vs. interdependence, and 4) self-advocacy. Medication self-management included subthemes of rescue medications, controller medications and medication avoidance. The social support theme included three subthemes: peer support, caregiver support and healthcare provider support. Findings suggest that adolescents with asthma form both short term and long term goals. Their goals indicated a need for guided support to facilitate a successful health care transition.
ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses, 2007
Allergic rhinitis is one of the most commonly treated disorders seen in otolaryngology office set... more Allergic rhinitis is one of the most commonly treated disorders seen in otolaryngology office settings. It is often difficult to distinguish the symptoms associated with allergic rhinitis from other causes of rhinitis. Many times these nasal symptoms can be effectively treated using nonspecific pharmacotherapeutic agents in conjunction with general information on ways to reduce exposure to allergens or irritants in the environment. When allergic rhinitis is suspected and a targeted treatment approach is needed, allergy testing can confirm the diagnosis and guide effective treatment for the condition. This paper discusses various methods for diagnosing inhalant allergies with a special focus on a newer approach to skin testing, known as modified quantitative testing or MQT. This paper also presents an overview of the immune response as it occurs in allergic rhinitis, along with a discussion of common inhalant allergens. Finally, this paper offers a general approach to allergy testing...
International forum of allergy & rhinology, 2014
Environmental control measures refer to using 1 or more interventions aimed at avoiding, reducing... more Environmental control measures refer to using 1 or more interventions aimed at avoiding, reducing, or eliminating allergens and irritants in the environment to improve symptoms of allergic rhinitis. Although avoiding known allergens is highly effective, completely eliminating an allergen from one's environment is often impractical or even impossible. The purpose of this work is to review evidence on the efficacy of various environmental control measures aimed at preventing the development of new sensitizations, reducing the progression of allergic rhinitis, and improving its symptoms and quality of life. Current literature examining the protective effects of specific measures such as breastfeeding and early pet exposure against the development of allergic diseases including allergic rhinitis has been inconclusive. Environmental measures such as frequently washing cats and dogs, encasing bedding within impermeable covers, air filtration, and chemicals can effectively reduce level...
ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses, 2013
Patients with rhinitis and rhinosinusitis are commonly treated in otolaryngologists' offices.... more Patients with rhinitis and rhinosinusitis are commonly treated in otolaryngologists' offices. Many of these patients have concurrent lower respiratory diseases such as asthma. The simultaneous presence of upper and lower airway diseases occurs frequently, and has resulted in the unified airway model, which describes the close relationships between these inflammatory diseases. Understanding the coexistence of respiratory illnesses has implications for the diagnosis and management of both upper and lower airway conditions. It is important for otolaryngologists and otolaryngology nurses to be aware of these common comorbid processes, and to evaluate for the presence of asthma in all patients with upper airway conditions such as rhinitis and rhinosinusitis. This paper will discuss the epidemiology, pathophysiology, mechanisms, and diagnosis and treatment considerations in patients with unified airway diseases.
ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses, 2013
Ear, nose, & throat journal, 2011
Otolaryngology–Head and Neck Surgery
Contemporary medical practice is grounded in rigorous scientific evidence in concert with best cl... more Contemporary medical practice is grounded in rigorous scientific evidence in concert with best clinical practices and informed shared decision making with patients. During these times of uncertainty, disruption, and even anxiety, it becomes critical that we engage with our patients and communities in thoughtful dialogue and realistic expectations regarding treatments surrounding COVID-19. The hope for a “miracle” cure and urgency to return back to normal times can stimulate irrational thought and behavior and even desperate measures by individuals or groups. It becomes especially important that we continue to use reasonable, informed clinical judgment in discussing the various options with patients.
Otolaryngology–Head and Neck Surgery
The coronavirus disease 2019 (COVID-19) pandemic has brought to light significant health inequiti... more The coronavirus disease 2019 (COVID-19) pandemic has brought to light significant health inequities that have existed in our society for decades. Blacks, Hispanics, Native Americans, and immigrants are the populations most likely to experience disparities related to burden of disease, health care, and health outcomes. Increasingly, national and state statistics on COVID-19 report disproportionately higher mortality rates in blacks. There has never been a more pressing time for us to enact progressive and far-reaching changes in social, economic, and political policies that will shape programs aimed at improving the health of all people living in the United States.
International Forum of Allergy & Rhinology
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2018
This plain language summary for patients serves as an overview in explaining hoarseness (dysphoni... more This plain language summary for patients serves as an overview in explaining hoarseness (dysphonia). The summary applies to patients in all age groups and is based on the 2018 "Clinical Practice Guideline: Hoarseness (Dysphonia) (Update)." The evidence-based guideline includes research to support more effective identification and management of patients with hoarseness (dysphonia). The primary purpose of the guideline is to improve the quality of care for patients with hoarseness (dysphonia) based on current best evidence.
Otolaryngology-Head and Neck Surgery
This plain language summary serves as an overview in explaining earwax (cerumen). The summary app... more This plain language summary serves as an overview in explaining earwax (cerumen). The summary applies to patients older than 6 months with a clinical diagnosis of earwax impaction and is based on the 2017 update of the Clinical Practice Guideline: Earwax (Cerumen Impaction). The evidence-based guideline includes research that supports diagnosis and treatment of earwax impaction. The guideline was developed to improve care by health care providers for managing earwax impaction by creating clear recommendations to use in medical practice.
Journal of the American Association of Nurse Practitioners
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2017
The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published ... more The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue of Otolaryngology-Head and Neck Surgery featuring the updated Clinical Practice Guideline: Earwax (Cerumen Impaction). To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 11 recommendations emphasize proper ear hygiene, diagnosis of cerumen impaction, factors that modify management, evaluating the need for intervention, and proper treatment. An updated guideline is needed due to new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials) and the need to add statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care.
Journal of the American Association of Nurse Practitioners, 2015
There is a niche for urgent care clinics as an alternate source of health care in the United Stat... more There is a niche for urgent care clinics as an alternate source of health care in the United States. This systematic review examines whether the use of urgent care clinics can improve access to care or if these facilities undermine continuity of primary care. Databases used were Cumulative Index for Nursing and Allied Health (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE). Articles from 2004 to 2014 were searched using keywords-access, barriers, continuity of care, nurse practitioner (NP), urgent care, retail clinic, emergency, and primary care. Urgent care clinics can improve access to care, but may also negatively impact continuity of care, preventative services, and ongoing management of chronic conditions. Barriers to primary care and benefits of urgent care are inversely related. Insufficient knowledge regarding navigation of the healthcare system, perceived urgency of medical need, and deflection of care contribute to use of urgent care over primary care. NPs are frontline healthcare providers essential to developing and maintaining successful communication and collaboration among providers across healthcare settings. In both primary care and urgent care facilities, NPs can ensure continuity of care, decreased healthcare costs, and optimized health outcomes for patients.
Clinical Drug Investigation, Feb 1, 2009
and have the potential for considerable clinical effects due to a lack of sleep and persistent da... more and have the potential for considerable clinical effects due to a lack of sleep and persistent daytime symptoms of somnolence and activity impairment. The primary objective of this investigation was to determine the effect of a 14-day course of once-daily evening administration of mometasone furoate 400 μg administered via a dry powder inhaler (MF-DPI 400 μg qd pm) on the overnight decline in pulmonary function observed in patients with nocturnal asthma. Methods: Eligible enrollees were between the ages of 18 and 60 years and had established mild to moderate asthma, with an improvement in forced expiratory volume in 1 second (FEV1) of >15% after administration of inhaled salbutamol (albuterol) 200 μg. All enrolled patients had a history of nocturnal asthma. Enrollees were randomized to receive MF-DPI 400 μg qd pm or placebo administered between 6pm and 8pm for 14 days. The primary outcome evaluated in the study was reduction in nocturnal decline in evening (8pm) to morning (6am) FEV1 values. Secondary outcomes included reduction in nocturnal decline in evening to morning peak expiratory flow rate (PEFR), polysomnographic indices of sleep, and psychometric indices (Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire [NRQLQ], 36-item Short Form of the Medical Outcomes Survey [SF-36], and Asthma Quality of Life Questionnaire [AQLQ]). Results: A total of 20 patients were randomized and completed all phases of the study. No significant differences were observed between treatment groups in the primary outcome of nocturnal decline in FEV1 from pretreatment to end of treatment. Likewise, there was no significant difference between treatment groups in polysomnographic indices of sleep or quality-of-life assessments. However,
Http Dx Doi Org 10 1080 00461528109529237, Oct 1, 2009
This article presents a comprehensive theoretical model of academic underachievement in students.... more This article presents a comprehensive theoretical model of academic underachievement in students. Past views of scholastic dysfunction have tended to focus on specific factors which psychologists have considered important, while failing to consider the problem on its broader level. The present model proposes that underachievement can be viewed as a complex interaction among three factors: (a) weaknesses in academic skills,
Nurs Res, 1982
This study examined the course and duration of the crisis inherent in the diagnosis and treatment... more This study examined the course and duration of the crisis inherent in the diagnosis and treatment of cancer in women. Three groups of female patients, breast cancer, gynecological cancer, and breast biopsy patients, were compared on the variables of depression and body image. The women were assessed prior to surgery and at one- and two-month intervals in order to determine whether their crises had been resolved within the normal six-month framework. An additional follow-up was made after 20 months to evaluate any long-term effects of the diagnosis of cancer or its treatment. Results of the study revealed that only breast biopsy and mastectomy patients adapted appropriately and were able to resolve their crises. In examining the gynecological cancer patients, initial feelings of depression and body image continued to worsen even at 20 months following surgery. Implications for nursing practice are discussed, and suggestions for future research are presented.
J Nurs Admin, 1988
Establishing a strong commitment to nursing research poses both rewards and challenges for nurse ... more Establishing a strong commitment to nursing research poses both rewards and challenges for nurse executives. The authors address the purpose and review process of the nursing research committee from the researcher's and reviewer's perspectives. A greater understanding of this process, its implications, and its benefits for nursing executives will further facilitate nursing research in the service setting.
Journal of Pediatric Nursing, 2015
Adolescence is a unique time of development incorporating a transition from child centered to adu... more Adolescence is a unique time of development incorporating a transition from child centered to adult centered health care. This transition period can be particularly challenging for individuals with a chronic disease such as asthma. Inadequate transition planning during adolescence may place an already vulnerable population such as African American adolescents with known health disparities in asthma prevalence, morbidity and mortality at risk for a continuation of poor health outcomes across the lifespan. Central to transition planning for these youth is the core element of developing and prioritizing goals. The purpose of this qualitative study was to explore the asthma self-management goals, beliefs and behaviors of urban African American adolescents prior to transitioning from pediatric to adult health care. A focus group composed of 13 African American adolescents with asthma ages 14-18years from an urban population was conducted. Responses from transcripts and field notes were reviewed using an iterative process to best characterize asthma self-management goals and beliefs that emerged. Four core themes were identified: 1) medication self-management, 2) social support, 3) independence vs. interdependence, and 4) self-advocacy. Medication self-management included subthemes of rescue medications, controller medications and medication avoidance. The social support theme included three subthemes: peer support, caregiver support and healthcare provider support. Findings suggest that adolescents with asthma form both short term and long term goals. Their goals indicated a need for guided support to facilitate a successful health care transition.
ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses, 2007
Allergic rhinitis is one of the most commonly treated disorders seen in otolaryngology office set... more Allergic rhinitis is one of the most commonly treated disorders seen in otolaryngology office settings. It is often difficult to distinguish the symptoms associated with allergic rhinitis from other causes of rhinitis. Many times these nasal symptoms can be effectively treated using nonspecific pharmacotherapeutic agents in conjunction with general information on ways to reduce exposure to allergens or irritants in the environment. When allergic rhinitis is suspected and a targeted treatment approach is needed, allergy testing can confirm the diagnosis and guide effective treatment for the condition. This paper discusses various methods for diagnosing inhalant allergies with a special focus on a newer approach to skin testing, known as modified quantitative testing or MQT. This paper also presents an overview of the immune response as it occurs in allergic rhinitis, along with a discussion of common inhalant allergens. Finally, this paper offers a general approach to allergy testing...
International forum of allergy & rhinology, 2014
Environmental control measures refer to using 1 or more interventions aimed at avoiding, reducing... more Environmental control measures refer to using 1 or more interventions aimed at avoiding, reducing, or eliminating allergens and irritants in the environment to improve symptoms of allergic rhinitis. Although avoiding known allergens is highly effective, completely eliminating an allergen from one's environment is often impractical or even impossible. The purpose of this work is to review evidence on the efficacy of various environmental control measures aimed at preventing the development of new sensitizations, reducing the progression of allergic rhinitis, and improving its symptoms and quality of life. Current literature examining the protective effects of specific measures such as breastfeeding and early pet exposure against the development of allergic diseases including allergic rhinitis has been inconclusive. Environmental measures such as frequently washing cats and dogs, encasing bedding within impermeable covers, air filtration, and chemicals can effectively reduce level...
ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses, 2013
Patients with rhinitis and rhinosinusitis are commonly treated in otolaryngologists' offices.... more Patients with rhinitis and rhinosinusitis are commonly treated in otolaryngologists' offices. Many of these patients have concurrent lower respiratory diseases such as asthma. The simultaneous presence of upper and lower airway diseases occurs frequently, and has resulted in the unified airway model, which describes the close relationships between these inflammatory diseases. Understanding the coexistence of respiratory illnesses has implications for the diagnosis and management of both upper and lower airway conditions. It is important for otolaryngologists and otolaryngology nurses to be aware of these common comorbid processes, and to evaluate for the presence of asthma in all patients with upper airway conditions such as rhinitis and rhinosinusitis. This paper will discuss the epidemiology, pathophysiology, mechanisms, and diagnosis and treatment considerations in patients with unified airway diseases.
ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses, 2013
Ear, nose, & throat journal, 2011