Medicine and Health Sciences Commons^™

An Enhanced Actualized Dnp Model To Improve Dnp Project Placements, Rigor, And Completion: A Research Brief, Marie Vanderkooi, Dianne Conrad, Sandra Spoelstra

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

Doctor of nursing practice (DNP) projects are summative evaluations of enactment of the DNP Essentials. However, information about structure, process, and outcomes of DNP projects is scarce. Guided by an enhanced actualized DNP model, this study tested the effect of a PhD-DNP-site mentor model to guide DNP projects. Time-to-complete assignments, defense, and graduation improved; high satisfaction for students, mentors, and faculty were found; and a strengthened academic-practice partnership occurred, leading to additional student placements. Broader testing of the enhanced model in various size and types of academic-practice settings is needed prior to use.

Vanderkooi Jnep 2018.Pdf, Marie Vanderkooi, Dianne Conrad, Sandra Spoelstra

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

No abstract provided.

Schroder 2018 Jags Circumstances.Pdf, Schroder Sattar, Sandra Spoelstra, Martine Puts

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

No abstract provided.

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

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

No abstract provided.

Policy Implications Of Oral Agents, Sandra L. Spoelstra, Barbara A. Given, Charles W. Given, Marcia Grant

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

OBJECTIVE: With the increasing use of oral antineoplastic agents in cancer management, patients and family members need to understand of how to obtain, safely handle, and store the medication, how and when the medications should be taken, and when to report toxic side effects to accomplish efficacious treatment. DATA SOURCES: Research based articles and conference presentations. CONCLUSION: Cancer centers to modify policies, protocols, or practices to assure safe and proper administration of oral antineoplastic agents. IMPLICATIONS FOR NURSING PRACTICE: Clinicians need to monitor and facilitate administration of oral antineoplastic agents, and ultimately improve clinical outcomes.

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 …

Mhealth Sms Text Messaging Interventions And To Promote Medication Adherence: An Integrative Review, Tracy Dekoekkoek, Barbara Given, Charles W. Given, Kimberly Ridenour, Monica Schueller, Sandra L. Spoelstra

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

Aims and objectives: This article is an integrative review of the evidence for mobile health Short Message Service text messages as an innovative and emerging intervention to promote medication adherence. Authors completed this review to draw conclusions and implications towards establishing a scientific foundation for use of text messages to promote medication adherence, thus informing clinical practice. Background: The World Health Organization has identified medication adherence as a priority global problem. Text messages are emerging as an effective means of improving health behaviours and in some diseases to promote medication adherence. However, a gap in the literature indicates lack of …

The Challenges Of Oral Agents As Antineoplastic Treatments, Barbara A. Given, Sandra L. Spoelstra, Marcia Grant

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

OBJECTIVE: Given the increasing use of oral antineoplastic agents in cancer management, patient adherence is critical to successful treatment outcomes. This article reviews the scope of the problem and issues of adherence to oral antineoplastic agents. DATA SOURCES: Research based and other articles, newsletters, and conference presentations. CONCLUSION: Suboptimal adherence to oral antineoplastic agents is a significant clinical problem that may result in disease or treatment complications, adjustment in treatment regimen, disease progression, and premature death. IMPLICATIONS FOR NURSING PRACTICE: Healthcare providers need to monitor and facilitate adherence by identifying barriers and implementing strategies to assure adherence, and therefore, improve …

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 …

Assessment And Measurement Of Adherence To Oral Antineoplastic Agents, Sandra L. Spoelstra, Charles W. Given

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

OBJECTIVES: The increase in oral anticancer medications with complex regimens creates a need to assure patients are taking therapeutic dosages as prescribed. This article reviews the assessment and measurement of adherence to oral antineoplastic agents. DATA SOURCE: Research and journal articles from CINAHL and Pub Med. CONCLUSION: Assessing and measuring adherence to oral antineoplastic should include three dimensions: the percentage of medications taken, the duration, and the timing of taking the medication. IMPLICATIONS FOR PRACTICE: Clinicians need to conduct ongoing assessment and measurement of adherence to oral antineoplastic agents. This includes eliciting patient report of adherence, pill counts, drug diaries, …

Fall Prevention In Hospitals: An Integrative Review, Sandra L. Spoelstra, Barbara A. Given, Charles W. Given

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

Purpose: This article summarize research and draws overall conclusions from the body of literature on fall prevention interventions to provide nurse administrators with a basis for developing evidence-based fall prevention programs in the hospital setting. Method: Data were obtained from published studies. Thirteen articles were retrieved that focused on fall interventions in the hospital setting. An analysis was performed based on levels of evidence using an integrative review process. Results: Multifactoral fall prevention intervention programs that included fall risk assessments, door/bed/patient fall risk alerts, environmental and equipment modifications, staff and patient safety education, medication management targeted to specific types, and …

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 …

An Intervention To Improve Adherence And Management Of Symptoms For Patients Prescribed Oral Chemotherapy Agents: An Exploratory Study, Sandra L. Spoelstra, Barbara A. Given, Charles W. Given, Marcia Grant, Alla Sikorskii, Mei You, Veronica Decker

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 Symptom Management …

A Qualitative Study Of Role Transition From Rn To Apn, Sandra L. Spoelstra, Lorraine B. Robbins

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

Role transition from registered nurse to advanced practice nurse is a difficult process. A qualitative thematic analysis guided the integration of various experiences of 24 students in a twocredit, web-based role development course in a Master’s of Science in Nursing program at a large Midwestern university. Findings supported that students had developed an understanding of the core competencies and complexity of the advanced practice nurse role, and that beginning role transition had occurred. An overarching theme, ‘the essence of nursing’ was evident. Three subthemes supported the occurrence of role transition, which included the importance of: a) building a framework for …

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 …

Interventions Combining Motivational Interviewing And Cognitive Behavior To Promote Medication Adherence: A Literature Review, Sandra L. Spoelstra, Monica Schueller, Melissa Hilton, Kimberly Ridenour

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

Aims and objectives: The World Health Organization has indicated medication adherence is a global problem. Both motivational interviewing (MI) and cognitive behavioral therapy (CBT) interventions alone have been found to be effective at improving medication adherence. This article summarizes research that has combined motivational interviewing and cognitive behavioral therapy to improve medication adherence. Background: Projections indicate that by 2015, 33% of cancer treatment will be in pill form, shifting responsibility for managing medication adherence to patients. These regimens are often complex, with multiple doses, drugs, or cycling, and patients often experience side effects from symptoms, making adherence difficult. Patients taking …

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, …

A Randomized Controlled Trial Of The Feasibility And Preliminary Efficacy Of A Texting Intervention On Medication Adherence In Adults Prescribed Oral Anti-Cancer Agents: Study Protocol, 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

Aim: The aim of this study was to report a study protocol that examines feasibility, preliminary efficacy and satisfaction of a text message intervention on the outcome of medication adherence in adult patients prescribed oral anti-cancer agents. Background: Administration of oral anti-cancer agents occurs in the home setting, requiring patients to self-manage the regimen as prescribed. However, many barriers to medication adherence exist: regimens are often complex, with cycling of two or more medications; side effects of treatment; most cancer patients are older with comorbid conditions and competing demands; and cognitive decline and forgetfulness may occur. Research indicates patients miss …

A Trial Examining An Advanced Practice Nurse Intervention To Promote Medication Adherence And Symptom Management In Adult Cancer Patients Prescribed Oral Anti-Cancer Agents: Study Protocol, Sandra L. Spoelstra, Peggy S. Burhenn, Tracy Dekoekkoek, Monica Schueller

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

Aim: To report a study protocol that refines then examines feasibility, preliminary efficacy, and satisfaction of ADHERE, an intervention using motivational interviewing and brief cognitive behavioral therapy as a mechanism for goal-oriented systematic patient education to promote symptom management and adherence among cancer patients prescribed oral anti-cancer agents. Background: Cancer treatment with oral anti-cancer agents shifts responsibility for managing treatment from clinicians in supervised cancer centers to patients and their caregivers. Thus, a need exists to standardize start-of-care for support patient self-management of care at home. Design: A two-phase quasi-experimental sequential design with repeated measures. Methods: Sixty five adult patients …

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 …

Translating Capable To Micapable In A State Waiver Program: Community Aging In Place For Better Elderly Living, Sandra Spoelstra

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

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

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

Feasibility Of A Text Messaging Intervention To Promote Symptom Management And Medication Adherence For Patients Prescribed Oral Anti-Cancer Agents, Sandra Spoelstra

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

Proof-Of-Concept And Preliminary Efficacy Of A Sms Text Messaging Intervention To Promote Symptom Management And Medication Adherence For Patients Prescribed Oral Anti-Cancer Agents: A Randomized Controlled Trial, Sandra Spoelstra

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

Assessment And Measurement Of Medication Adherence: Ons Pep Oral Anti-Cancer Agents, Sandra Spoelstra

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

Ons Pep Putting Evidence Into Practice: Evidence-Based Interventions For Oral Anti-Cancer Agents, Sandra Spoelstra

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

Feasibility Of A Text Messaging Intervention To Promote Symptom Management And Medication Adherence For Patients Prescribed Oral Anti-Cancer Agents, Sandra Spoelstra

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

Acceptability And Preliminary Efficacy Of A Sms Text Message Intervention In Older Cancer Patients, Sandra Spoelstra

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

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

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

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

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