The overall purpose of this study is to examine the longterm physical and psychosocial effects of Type A botulism on 27 patients and their families from a nursing perspective. These patients and families were involved in the outbreak of botulism occurring in Peoria, Illinois in October, 1983. Opportunities to observe the effects of botulism have been limited, and reports in the literature are scanty. This essentially descriptive study seeks to examine the botulism patients' physical and psychosocial status at 18, 24, and 36 months post-outbreak, and also the patients' and families' responses to botulism in the context of a crisis and a catastrophic illness. Moos and Tsu's conceptual framework of critical illness is used. Specifically the research seeks to answer the following specific questions: 1) What actual and perceived impairments of physical functioning are present at 18, 24 and 36 months post-outbreak as measured by the Pearson and Byars fatigue checklist, cranial nerve assessment, pulmonary function parameters, the Sickness Impact Profile, hand grip strength, and lateral pinch measures? 2) What is the status of their psychosocial functioning as measured by the Sickness Impact Profile, the Jalowiec Coping Scale, the Norbeck Support Systems Questionnaire, the support systems profile, and the psychosocial nursing assessment interview at 18, 24 and 36 months? 3) What are the subjectively identified physical and psychosocial problems faced by the victims and their families in the home as measured by the subjective home problem forms, and how are the problems being addressed? 4) How do patients and families respond to botulism as a crisis and a catastrophic illness as measured by the Psychosocial Nursing Assessment Interview at 18, 24 and 36 months and the Nurse Psychotherapist Family Interview at 18 months? 5) How do patients and families describe problems in family dynamics as measured by the above two tools? 6) How do patients and families negotiate readjustments in family life following the patients return home as measured by the above tools? 7) What are the home health and nursing care needs perceived by the patients and families as measured by open-ended interview questions and information obtained in questions 1-6? Collection, analysis and dissemination of the above will be invaluable for nurses to assist victims of future botulism outbreaks, and knowledge gained can be applied to other illnesses that are crises and devastating illnesses as well.
