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Medicine and Health Sciences

Selected Works

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Articles 1 - 18 of 18

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Oral Anticancer Agents: An Intervention To Promote Medication Adhrence And Symptom Management, Sandra Spoelstra Dec 2016

Oral Anticancer Agents: An Intervention To Promote Medication Adhrence And Symptom Management, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

No abstract provided.

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Testing The Differential Effects Of Symptom Management Interventions In Cancer, Alla Sikorskii, Charles W. Given, Azfar-E-Alam Siddiqi, Victoria Champion, Ruth Mccorkle, Sandra L. Spoelstra, Barbara A. Given Jun 2016

Testing The Differential Effects Of Symptom Management Interventions In Cancer, Alla Sikorskii, Charles W. Given, Azfar-E-Alam Siddiqi, Victoria Champion, Ruth Mccorkle, Sandra L. Spoelstra, Barbara A. Given

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Objective: The purpose of this study was to test for moderating effects of patient characteristics on self-management interventions developed to address symptoms during cancer treatment. Patient’s age, education and depressive symptomatology were considered as potential moderators. Methods: A secondary analysis of data of 782 patients from two randomized clinical trials was performed. Both trials enrolled patients with solid tumors undergoing chemotherapy. After completing baseline interviews, patients were randomized to a nurse-delivered intervention versus intervention delivered by a “coach” in trial I, and to a nurse-delivered intervention versus an intervention delivered by an automated voice response system in trial II. In …

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Proof Of Concept Of A Mobile Health Short Message Service Text Message Intervention That Promotes Adherence To Oral Anticancer Agent Medications: A Randomized Controlled Trial, Sandra L. Spoelstra, Charles W. Given, Alla Sikorskii, Constantinos K. Coursaris, Atreyee Majumder, Tracy Dekoekkoek, Monica Schueller, Barbara A. Given Jun 2016

Proof Of Concept Of A Mobile Health Short Message Service Text Message Intervention That Promotes Adherence To Oral Anticancer Agent Medications: A Randomized Controlled Trial, Sandra L. Spoelstra, Charles W. Given, Alla Sikorskii, Constantinos K. Coursaris, Atreyee Majumder, Tracy Dekoekkoek, Monica Schueller, Barbara A. Given

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Introduction: This multisite, randomized controlled trial assigned 75 adult cancer patients prescribed an oral anticancer agent to either an experimental group that received daily text messages for adherence for 21 days plus usual care or a control group that received usual care. Materials and Methods: Measures were administered at baseline, weekly (Weeks 1–8), and at exit (Week 9). A satisfaction survey was conducted following the intervention. Acceptability, feasibility, and satisfaction were examined. Primary outcomes were adherence and symptoms. Secondary outcomes were depressive symptoms, self-efficacy, cognition, physical function, and social support. Mixed or general linear models were used for the analyses …

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Development Of An Index To Predict Risk Of Nursing Home Placement For Home And Community-Based Waiver Participants, Sandra L. Spoelstra, Charles W. Given Jun 2016

Development Of An Index To Predict Risk Of Nursing Home Placement For Home And Community-Based Waiver Participants, Sandra L. Spoelstra, Charles W. Given

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Nursing home placement (NHP) is costly, and the majority of older adults prefer to remain living in the community. The purpose of this research was to examine NHP among a cohort of participants in a home and community-based waiver program during 2002 to 2007 to develop a risk model for predicting who may transition to a nursing home. Methods: This longitudinal study was conducted on data from the minimum data set-home for care linked with medicaid claim files and death certificates. The sample included 6525 participants who had two assessments and survived through 2007 or had NHP. A risk index …

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How Increasing Personal Care Service Might Delay Or Prevent Nursing Home Placement, Sandra L. Spoelstra, Charles W. Given, Tracy Dekoekkoek, Monica Schueller Jun 2016

How Increasing Personal Care Service Might Delay Or Prevent Nursing Home Placement, Sandra L. Spoelstra, Charles W. Given, Tracy Dekoekkoek, Monica Schueller

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

There is a pressing need to retain dually eligible elderly Medicare and Medicaid beneficiaries in the community. The objective of this study was to examine median personal care services (PCS) hours, and how increasing PCS to the median (for those below), might delay nursing home placement (NHP) and save cost. Methods: Retrospective study of PCS hours, costs, and NHP in a statewide home and community based waiver program in the Midwest serving 6525 dually eligible Medicare-Medicaid beneficiaries aged 65 and older. Two Minimum Data Set-Home Care assessments and Medicaid claim files were examined to identify PCS hours and cost. A …

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Falls In The Community Dwelling Elderly With A History Of Cancer, Sandra L. Spoelstra, Barbara Given, Alexander Von Eye, Charles W. Given Jun 2016

Falls In The Community Dwelling Elderly With A History Of Cancer, Sandra L. Spoelstra, Barbara Given, Alexander Von Eye, Charles W. Given

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

BACKGROUND: Falls place older adults at risk for injuries, resulting in functional decline, hospitalization, institutionalization, higher healthcare costs, and decreased quality of life. OBJECTIVE: This study examined community-dwelling elderly to identify if individuals with a history of cancer fall at a higher rate than those without cancer, and if the occurrence of falls was influenced by individual characteristics, symptoms, or function. METHODS: This was a retrospective, cross-sectional study, in 2007, examining 7,448 community-dwelling elderly 65 years or older in a state in the Midwest. Fallers were identified based on a diagnosis of cancer, age, sex, race and ethnicity, poor vision, …

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A Pilot Study Of An Automated Voice Response System And Nursing Intervention To Monitor Adherence To Oral Chemotherapy Agents, Veronica Decker, Sandra L. Spoelstra, Emily Miezo, Renee Bremer, Mei You, Charles W. Given, Barbara A. Given Jun 2016

A Pilot Study Of An Automated Voice Response System And Nursing Intervention To Monitor Adherence To Oral Chemotherapy Agents, Veronica Decker, Sandra L. Spoelstra, Emily Miezo, Renee Bremer, Mei You, Charles W. Given, Barbara A. Given

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

This study was designed to develop and test a system to monitor adherence with non-hormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants received the Symptom Management Toolkit then participated in an interview for symptom severity, satisfaction, and beliefs about oral agents. Patients received weekly AVR calls, which assessed adherence to oral agents and severity of 15 symptoms. Patients who reported adherence of < 100% of prescribed oral agents or symptoms of 4 or greater (0-10 scale) for three consecutive weeks, were called by a nurse for assistance with symptom management and adherence to oral …

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Recruitment & Enrollment Of Older Adults Into Mobile Phone Text Message Clinical Trials, Sandra Spoelstra Nov 2015

Recruitment & Enrollment Of Older Adults Into Mobile Phone Text Message Clinical Trials, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Poster Presentation

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The Symptom Experience While Taking Oral Anti-Cancer Medication (Chemotherapy Or Targeted Agents), Sandra Spoelstra Dec 2013

The Symptom Experience While Taking Oral Anti-Cancer Medication (Chemotherapy Or Targeted Agents), Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Background: Over 50-oral agents are on the market, and within three years, 25% of treatment will be in pill form, shifting the responsibility for symptom management to the patients. Symptoms need to be managed so they do not become so severe that it leads to reducing or stopping the medication, potentially rendering the cancer treatment ineffective. A gap in the literature exists, with no studies reporting the symptom experience of patients taking oral agents. Prior to developing interventions for patients at home setting on oral agents, we need to determine if symptoms are similar to those treated with IV chemotherapy. …

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Symptom Attribution Of Older Cancer Patients With Comorbid Conditions During Chemotherapy Treatment, Sandra Spoelstra Dec 2013

Symptom Attribution Of Older Cancer Patients With Comorbid Conditions During Chemotherapy Treatment, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Background:Over  60% of those who are diagnosed with cancer are older adults, and 75% have comorbid conditions. 15% of cancer treatment is now in pill form; and it is expected to grow to 25% within 3-years.  Having comorbid conditions in addition to cancer may exacerbate symptom severity. As a consequence of these symptoms, some patients adjust, interrupt, or stop dosages of the oral agent, which may affect cancer treatment.
                                                                                                                               
Purpose: This study describes the attribution of symptoms (fatigue, pain, numbness/tingling, sleep disturbance, diarrhea, distress, swelling in hands/feet, lack of appetite, constipation, shortness of breath, redness/swelling/pain in hands or …

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Translating Evidence-Based Care In A State Waiver Program To Reduce Transitions, Sandra Spoelstra Dec 2013

Translating Evidence-Based Care In A State Waiver Program To Reduce Transitions, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Disability reflects a gap between an individual’s abilities and the environment in which they function, and is the primary modifiable factor in preventing institutionalization. We report on a pilot study testing dissemination and implementation of a proven intervention, intervening directly on pain, medication management, strength and balance, depression and the home environment, in the State of Michigan waiver program to reduce re-institutionalization. We are enrolling 20 clients who were hospitalized or nursing home within the past 14-days, and providing the intervention plus usual waiver services. We will compare those 20 to a match (age, race, gender) cohort from 2012 who …

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An Intervention To Improve Adherence And Symptoms For Oral Oncolytics, Sandra Spoelstra Dec 2012

An Intervention To Improve Adherence And Symptoms For Oral Oncolytics, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Background. The use of oral chemotherapy agents to treat cancer has increased. Patients are responsible for adhering to complex dosing regimens, while monitoring and managing symptoms from side effects of the chemotherapy at home.
 
Objective. This study examined an intervention to manage symptoms and promote adherence to oral chemotherapy agents.
 
Intervention and Methods. A 3 group exploratory pilot study determined how an Automated Voice Response (AVR) system alone (N=40), or the AVR with strategies to manage symptoms and adherence (N=40), or the AVR with strategies to manage adherence (N=39) reduced symptom severity and improved adherence. Participants received a …

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Symptom Severity, Symptom Attribution, And Preference For Assistance While Taking Chemotherapy Or Targeted Agents, Sandra Spoelstra Dec 2012

Symptom Severity, Symptom Attribution, And Preference For Assistance While Taking Chemotherapy Or Targeted Agents, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Significance: When taking oral agents, patients need to manage symptoms so that they do not become so severe that it leads to decreased function and difficulty with activities of daily living, and reducing or stopping the medication, rendering the cancer treatment ineffective.
 
Problem & Purpose: Over fifty oral anti-cancer agents are currently on the market, and within three years, 25% of treatment will be delivered in pill form, shifting treatment to the responsibility of patients. This study describes symptoms from oral agents, attribution of symptoms, and preference for assistance. 
 
Framework: Not applicable.
 
Methods: Thirty cancer patients taking …

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Development Of A Risk Index To Predict Transfers From Home And Community-Based Waiver Programs To Nursing Homes: Can Care Managers Assist Older Adults To Delay Nursing Home Placement?, Sandra Spoelstra Dec 2012

Development Of A Risk Index To Predict Transfers From Home And Community-Based Waiver Programs To Nursing Homes: Can Care Managers Assist Older Adults To Delay Nursing Home Placement?, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Purpose: This research examines the risk of nursing home placement (NHP) among an inception cohort of 6525 older adults entering a statewide home and community-based waiver program between 2002—2007.
 
Background: With adults aged 65 and older currently comprising 15% of the population and growing exponentially, concern is mounting as to how to care for this group. It will be important to deliver high-quality care tailored to the needs of clients in order to allow these individuals to remain living in the community. Most older adults prefer to remain in their homes but are forced to transfer to NHs because …

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Determining Preferences For Symptom Management Assistance While Taking Oral Anti-Cancer Agent Pills, Sandra Spoelstra Dec 2012

Determining Preferences For Symptom Management Assistance While Taking Oral Anti-Cancer Agent Pills, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Nearly 50 oral anti-cancer agents are on the market, and it’s projected that in 3 years, 25% of chemotherapy will be delivered in pill form. Thus, patients must take responsibility for managing symptoms at home. This was an 8-week exploratory study of cancer patients on oral agents from 3 cancer centers in the Midwest. Baseline interviews collected characteristics, type/stage of cancer, symptoms, and comorbid conditions. Patients were asked preference for information to help manage symptoms. Mean age was 65.2 years, 50% were Female, 87% Caucasian and 13% African American. Preference for obtaining symptom management information included: 37% phone calls, 27% …

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Explaining Transfers From Home And Community Based Waiver Program To Nursing Home: Can Patients Stay At Home?, Sandra Spoelstra Dec 2010

Explaining Transfers From Home And Community Based Waiver Program To Nursing Home: Can Patients Stay At Home?, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Purpose Among6,836 medically and economically vulnerable older persons enrolled in a Home and Community Based Waiver (HCBW) program between 2003 and 2007 we compare those who remain at home with those who transfer to a nursing home (NH).
 
Background NHs is costly, averaging over $70,000 per year. Beyond escalating financial concerns, there are a constellation of potentially negative outcomes associated with NH admission, and most older adults prefer to remain in their homes but are forced to transfer to NHs because community supports are inadequate to meet their needs.
 
Methods Those who remained at home (4343) and NH …

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The Influence Of Cancer On Falls In Community Dwelling Elderly, Sandra Spoelstra Dec 2008

The Influence Of Cancer On Falls In Community Dwelling Elderly, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Cancer survivors are living longer, and encounter physical, psychosocial, and economic impacts until the end of life. However studies examining whether a cancer diagnosis alters the rate of falls in elderly survivors are rare. This retrospective, longitudinal cohort study examined community dwelling elderly in a home based waiver program to identify if individuals with a diagnosis of cancer experience falls at a higher rate than those without cancer. The Minimum Data Set in a State in the Midwest was used to examine cancer, age, gender, race and ethnicity, poor vision, reduced ADLs, reduced IADLS, cognitive skill, incontinence, pain, or depression …

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The Influence Of Cancer On Falls In Community Dwelling Elderly, Sandra Spoelstra Dec 2008

The Influence Of Cancer On Falls In Community Dwelling Elderly, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Cancer survivors are living longer, and encounter physical, psychosocial, and economic impacts until the end of life. However studies examining whether a cancer diagnosis alters the rate of falls in elderly survivors are rare. This retrospective, longitudinal cohort study examined community dwelling elderly in a home based waiver program to identify if individuals with a diagnosis of cancer experience falls at a higher rate than those without cancer. The Minimum Data Set in a State in the Midwest was used to examine cancer, age, gender, race and ethnicity, poor vision, reduced ADLs, reduced IADLS, cognitive skill, incontinence, pain, or depression …

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