J Lander

University of Alberta, Edmonton, Alberta, Canada

Are you J Lander?

Claim your profile

Publications (22)77.64 Total impact

  • J Lander, F Warnock
    [Show abstract] [Hide abstract]
    ABSTRACT: Certainly, day surgery helps reduce health care costs, but what are the effects on the families of children undergoing surgical procedures and same-day discharge? Our research was aimed at identifying the family outcomes of day surgery, and making recommendations for change as appropriate.
    The Canadian nurse 03/1999; 95(2):29-33.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Anxiety is an important component of children's pain and is routinely assessed in pain research. Two forms of the State-Trait Anxiety Inventory have been used frequently by researchers investigating children's pain and state anxiety (form C-1 and Y-1). We were unable to find psychometric information about this tool when used with a population of hospitalized children. Therefore, we undertook to assess reliability and validity, and identify problem items using data from 881 hospitalized children (aged 5-18 years) whom we had tested. Considering results of all analyses together, we concluded that the tools lack validity and reliability, and contain many problem items that are in need of revision.
    Journal of Pain and Symptom Management 09/1998; 16(2):80-6. · 2.60 Impact Factor
  • F F Warnock, J Lander
    AARN news letter 07/1998; 54(6):17.
  • J Lander
    Clinical Nursing Research 06/1998; 7(2):99-102. · 0.86 Impact Factor
  • F F Warnock, J Lander
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study was to assess outcomes of pediatric day surgery tonsillectomy. A total of 129 children, aged 5-16 years, and their parents were recruited from three urban hospitals which provided pediatric day surgery. Children reported pain on a visual analogue scale (VAS) in day surgery and then daily at home for 7 days. Parents reported outcomes of surgery, including fluid intake, nausea, vomiting and sleep disturbances. They also recorded analgesic administration. Three main results related to extent and duration of pain, quality of management of pain, and effect of pain on utilization of health services. Tonsillectomy caused considerable pain which lasted more than 7 days. Pain followed a trajectory of intense or moderately intense pain for the first 3 days followed by a gradual decline over the next 4 days. In general, post-tonsillectomy pain was poorly managed by health professionals and parents. An unexpected observation was that children who had a bupivacaine infiltration of the tonsil fossa during surgery had significantly more pain in the evening of surgery than children who did not have an infiltration. The increase in postoperative pain experienced by those who had the infiltration was attributed to quality of pain management. Children with persistent pain (those who did not follow the typical trajectory) were likely to be taken to a medical practitioner. One-third of the sample made unscheduled visits to practitioners with most occurring from Day 4 to Day 7 of the follow-up.
    Pain 04/1998; 75(1):37-45. · 5.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Beliefs about the safety and effectiveness of current anesthetics have resulted in many newborns being circumcised without the benefit of anesthesia. To compare ring block, dorsal penile nerve block, a topical eutectic mixture of local anesthetics (EMLA), and topical placebo when used for neonatal circumcision. The placebo represented current practice, with no anesthetic for neonatal circumcision. A randomized controlled trial. Antenatal units in 2 tertiary care hospitals in Edmonton, Alberta. A consecutive sample of 52 healthy, full-term, male newborns, aged 1 to 3 days. Physiological and behavioral monitoring occurred in a series of trials: baseline, drug application, preparation, circumcision, and postcircumcision. Surgical procedures defined the following 4 stages of the circumcision: cleansing, separation, clamp on, and clamp off. Methemoglobin level was assessed 6 hours after surgery. Heart rate, cry, and methemoglobin level. Newborns in the untreated placebo group exhibited homogeneous responses that consisted of sustained elevation of heart rate and high-pitched cry throughout the circumcision and following. Two newborns in the placebo group became ill following circumcision (choking and apnea). The 3 treatment groups all had significantly less crying and lower heart rates during and following circumcision compared with the untreated group. The ring block was equally effective through all stages of the circumcision, whereas the dorsal penile nerve block and EMLA were not effective during foreskin separation and incision. Methemoglobin levels were highest in the EMLA group, although no newborn required treatment. The most effective anesthetic is the ring block; EMLA is the least effective. It is our recommendation that an anesthetic should be administered to newborns prior to undergoing circumcision.
    JAMA The Journal of the American Medical Association 01/1998; 278(24):2157-62. · 29.98 Impact Factor
  • M J Hodgins, J Lander
    [Show abstract] [Hide abstract]
    ABSTRACT: Children's strategies for coping with the pain and distress of venipuncture were examined in this descriptive study. Eighty-five children (aged 5-13 years) were interviewed prior to and following blood collection. Prior to the procedure, children reported pain expectations and coping strategies that might be used. Self-reports of the pain experienced and coping strategies used were obtained immediately after the procedure. Twenty-seven different strategies were identified from the children's responses. These strategies were subsequently grouped into 11 coping categories: Active Involvement in Procedure, Behavior-Regulating Cognitions, Cognitive Reappraisal, Direct Efforts to Maintain Control, Diversionary Thinking, Emotion-Regulating Cognitions, Information Seeking, Reality-Oriented Working Through, Reliance on Health-Care Interventions, Support Seeking, and Avoidance and Catastrophizing. Direct Efforts to Maintain Control was the most frequently used category. Age and gender differences were observed in both number and type of strategies reported by the children. Further research is needed to examine the observed relationship between the type of coping strategies generated and the children's pain experience.
    Journal of Pain and Symptom Management 06/1997; 13(5):274-85. · 2.60 Impact Factor
  • J Lander
    [Show abstract] [Hide abstract]
    ABSTRACT: To assess a strategy to improve 288 nurses' clinical decisions about management of pain saliency of information and cue about the information were manipulated. Scores indicated that the combination of vivid information and a cue to use the information led to the best decisions.
    Perceptual and Motor Skills 05/1997; 84(2):573-4. · 0.49 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although EMLA is known to be an effective topical anesthetic, its rate of success is unknown. Indeed, researchers have suggested that EMLA may fail with young and apprehensive children. Therefore, the objectives of this study were to assess EMLA's rate of success as well as factors which predict success. A double-blind, placebo-controlled design was utilized. The sample included 258 children and adolescents aged 5-18 years who were having venipuncture or intravenous (i.v.) cannulation. After having their anxiety assessed, subjects were randomly assigned to have EMLA or placebo applied over the procedure site for 90 min. The visual analogue scale was used to assess pain caused by removal of the semi-permeable dressing and by the procedure. Other information that was collected included: duration of drug application, interval between drug removal and procedure, skin changes at bandage and drug sites and rated difficulty of the procedure. EMLA was successful 84% of the time for venipuncture and 51% of the time for i.v. cannulation. Factors which predicted success of EMLA included type of procedure, duration of drug application and anxiety. EMLA was less successful for i.v. cannulation compared to venipuncture even with duration of drug application controlled. Those who had a poor outcome were more anxious than those with a good outcome. Age of child was not a factor. Strategies for improving efficient use of EMLA were recommended.
    Pain 02/1996; 64(1):89-97. · 5.64 Impact Factor
  • Nursing Research 01/1996; 45(1):50-3. · 1.56 Impact Factor
  • B Givens, S Oberle, J Lander
    [Show abstract] [Hide abstract]
    ABSTRACT: Typically, health professionals regard injections and venipuncture as routine for them and a minor nuisance for the patient. Yet for others, needles arouse dread and anxiety. This fear of needles may even lead some people to avoid dental and health care.
    The Canadian nurse 12/1993; 89(10):37-40.
  • Source
    J Lander, S Fowler-Kerry
    [Show abstract] [Hide abstract]
    ABSTRACT: A 3 x 6 factorial design with a double blind and placebo control was employed to investigate the effect of TENS treatment on pain produced by venipuncture. The three treatment groups consisted of TENS, placebo-TENS and control. Subjects were blocked into six 2-year age groups (ages: 5-17 years). During the period of the study, 896 children attending the outpatient laboratory of a general hospital were screened and 514 children completed the study. The data which were collected before venipuncture included expected pain and state anxiety. Following venipuncture, pain intensity was measured with a vertical visual analogue scale (VAS) and pain affect was assessed with McGrath's faces scale. Significant main effects for treatment and age groups were obtained. Pain intensity and affect were lowest for the TENS group and highest for the control group. The pain scores were greatest for lower age groups and lowest for higher age groups. The results of this study support the use of TENS for children's pain and the need for interventions for children's procedural pain.
    Pain 03/1993; 52(2):209-16. · 5.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Several aspects of venipuncture technique were evaluated to assess their relationship to reported pain. Subjects were 514 children aged 5-17 who had venipuncture performed by a technician in a hospital outpatient laboratory. A research assistant timed the duration of venipuncture and then obtained visual analogue pain scores from the children following venipuncture. Blood volume obtained from venipuncture was also measured. The technician who performed the procedure, amount of blood drawn, and time required to complete the venipuncture did not contribute to the prediction of children's pain. Age and anxiety, which were treated as covariates, were significant predictors of pain. The distribution of pain experienced by children was positively skewed and about one-third of children were above the mean pain score. From the results of this study, venipuncture pain can be recommended for the study of issues in children's pain. Further, the findings recommend the development and utilization of interventions to reduce children's venipuncture pain.
    Journal of Pain and Symptom Management 09/1992; 7(6):343-9. · 2.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A cross-sectional descriptive design was utilized to explore expected, experienced and recalled pain, and anxiety. Subjects were 138 children (5-17 yr) who were attending an outpatient laboratory for venipuncture. They reported state anxiety and expected visual analogue scale pain prior to having venipuncture. Following venipuncture, they reported sensory and affective pain. Two months afterward, subjects were contacted and asked to recall sensory and affective pain from the venipuncture. Analysis of data determined that children's recall of pain was quite good although better for affective pain than sensory pain. Prediction accuracy for pain was not good. From analysis it was determined that overestimation of pain was related to anxiety but not to greater experienced pain. Four patterns of responses were identified when prediction and recall accuracy were further examined. These patterns were designated as realism, irrelevance, over-reaction and denial. It was suggested that these patterns of response may provide clues about avoidance and coping behavior for children's pain. In general, the results of this study did not support previous research. It was demonstrated that various statistical techniques which have been employed in research on this topic have influenced the interpretation of pain prediction and recall data.
    Behaviour Research and Therapy 04/1992; 30(2):117-24. · 3.30 Impact Factor
  • S Fowler-Kerry, J Lander
    [Show abstract] [Hide abstract]
    ABSTRACT: Examined venipuncture pain and anxiety among 90 male and 90 female children and adolescents (5 to 17 years) who were attending a hospital laboratory. The purpose of the study was to assess sex differences in pain. Ss reported state anxiety and expected pain prior to having venipuncture and sensory and affective pain following venipuncture. Analysis of data determined that male and female were alike regarding age, state anxiety, expected pain, and perceived sensory and affective venipuncture pain. From analysis of pain estimation errors, it was found that males were significantly more likely to underestimate pain and females were significantly more likely to overestimate pain. These findings were discussed in terms of implications for coping research and for clinical practice.
    Journal of Pediatric Psychology 01/1992; 16(6):783-93. · 2.91 Impact Factor
  • J Lander, S Fowler-Kerry
    [Show abstract] [Hide abstract]
    ABSTRACT: A cross-sectional study of venipuncture pain and anxiety was conducted with 180 consecutively referred children and their parents. Analysis indicated that younger children report more venipuncture pain than older children. Anxiety was related to both age and pain. As well, anxiety was lowest among children with no previous venipuncture experience and among those with the greatest experience.
    Perceptual and Motor Skills 11/1991; 73(2):415-8. · 0.49 Impact Factor
  • J Lander
    [Show abstract] [Hide abstract]
    ABSTRACT: From research reports published over the last 20 years, it appears that moderate to severe uncontrolled pain may be the norm for hospitalized patients despite recent advances in the management of pain. Research on the extent of under-management of pain and the factors associated with it is examined and summarized in this paper. Methodological imperfections of the research are identified. Several explanations for pain under-management have been proposed and these are reported. A clinical decision making model is also reviewed and it is suggested that this model could be applied to pain management problems. Further, it is suggested that this model may be very useful in developing educational interventions to improve health practitioners' clinical skills in pain management.
    Pain 08/1990; 42(1):15-22. · 5.64 Impact Factor
  • J Lander
    [Show abstract] [Hide abstract]
    ABSTRACT: Research has indicated that approximately three-quarters of patients in acute care hospitals experience moderate to severe pain. It is thought that inadequately controlled pain is the result of poor clinical performance on the part of nurses and physicians. Faculty knowledge about pain mechanisms and pharmacology have been targeted as the source of their poor performance. In addition, practitioners may have fallacious beliefs about narcotics and pain. This study examined some of the misconceptions nurses have about addiction and pain management. A number of fallacies were identified. These included a very strong opiophobia or fallacy about addiction liability of narcotics even under conditions of normal hospital use.
    British journal of addiction 07/1990; 85(6):803-9.
  • J Lander, S Fowler-Kerry, A Hill
    The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières 02/1990; 22(1):39-49.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Studies have shown that women report more pain than men when pain is induced in the laboratory. As sex differences in perceived pain have not been established with clinical or endogenous pain, research was undertaken to compare reported pain of males and females arising from one of three sources. Two groups of adults and one group of children were studied. Analysis indicated no sex differences in reported clinical or endogenous pain for children or adults.
    Perceptual and Motor Skills 07/1989; 68(3 Pt 2):1088-90. · 0.49 Impact Factor