Medicine and Health Sciences Commons^™

Pmh Connect, English (Greyscale For Printing), Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Pmh Connect, EspañOl_Full Color, Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Pmh Connect, EspañOl_Greyscale For Printing, Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Pmh Connect, English, Full Color, Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Cultural Distress: An Emerging Paradigm, Christine Dewilde, Candace W. Burton

School of Nursing Publications

Although cultural competence in practice is a common goal within the health care professions, little is known about the consequences of a lack of such competence in health and healing. We propose a novel theoretical framework of cultural distress to describe patient experiences of and reactions to care that does not incorporate attention to cultural needs. Use of the cultural distress model to guide research offers an innovative framework by which researchers may identify potential interventions such that patients never reach a level of cultural distress.

Factors Distinguishing Positive Deviance Among Low-Income African American Women: A Qualitative Study On Infant Feeding, Cecilia E. Barbosa, Saba W. Masho, Kellie E. Carlyle, Maghboeba Mosavel

School of Nursing Publications

Background: Positive deviant individuals practice beneficial behaviors in spite of having qualities characterizing them as high risk for unhealthy behaviors.

Objective: This study aimed to identify and understand factors distinguishing low-income African American women who breastfeed the longest (positive deviants) from those who breastfeed for a shorter duration or do not breastfeed.

Methods: Seven mini-focus groups on infant-feeding attitudes and experiences were conducted with 25 low-income African American women, grouped by infant-feeding practice. Positive deviants, who had breastfed for 4 months or more, were compared with formula-feeding participants who had only formula fed their babies and short-term breastfeeding participants who …

Feasibility Of A Relaxation Guided Imagery Intervention To Reduce Maternal Stress In The Nicu, Lois C. Howland, Nancy Jallo, Cynthia D. Connelly, Rita H. Pickler

School of Nursing Publications

Objective: To test the feasibility of a relaxation guided imagery (RGI) intervention for mothers of hospitalized preterm infants and to explore the biobehavioral effects of RGI on their distress, responsiveness, and physiological stress.

Design: Single sample, pretest-posttest design.

Setting: A large Level III NICU in Southern California.

Participants: Twenty mothers of hospitalized preterm infants (24-32 weeks gestational age).

Methods: Correlational analyses of RGI use with self-reported measures of distress (perceived stress, state anxiety, and depression symptoms), awakening salivary cortisol level, and salivary cortisol awakening response collected from mothers at baseline and after 8 weeks of an RGI intervention.

Results: Nineteen …

Increasing Role Of Nurse Practitioners In House Call Programs, Nengliang (Aaron) Yao, Karen Rose, Virginia Lebaron, Fabian Camacho, Peter Boling

School of Nursing Publications

Objectives

Residence-based primary care provides homebound frail patients with a care plan that is individually tailored to manage multiple chronic conditions and functional limitations using a variety of resources. We (1) examine the visit volume and Medicare payments for residence-based health care provided by nurse practitioners (NPs) in the Medicare fee-for-service environment; (2) compare NP's residential visits to those of internists and family physicians; and (3) compare the geographical service area of full-time house call NPs versus NPs who make nursing facility visits a major portion of their work.

Design

An observational study using secondary data.

Setting

Medicare Provider Utilization …

Decreased Interleukin-4 Release From The Neurons Of The Locus Coeruleus In Response To Immobilization Stress, Hyun-Ju Lee, Hyun-Jung Park, Angela Starkweather, Kyungeh An, Insop Shim

School of Nursing Publications

It has been demonstrated that immobilization (IMO) stress affects neuroimmune systems followed by alterations of physiology and behavior. Interleukin-4 (IL-4), an anti-inflammatory cytokine, is known to regulate inflammation caused by immune challenge but the effect of IMO on modulation of IL-4 expression in the brain has not been assessed yet. Here, it was demonstrated that IL-4 was produced by noradrenergic neurons in the locus coeruleus (LC) of the brain and release of IL-4 was reduced in response to IMO. It was observed that IMO groups were more anxious than nontreated groups. Acute IMO (2 h/day, once) stimulated secretion of plasma …

Il-4 Inhibits Il-1Β-Induced Depressive-Like Behavior And Central Neurotransmitter Alterations, Hyun-Jung Park, Hyun-Soo Shim, Kyungeh An, Angela Starkweather, Kyung Soo Kim, Insop Shim

School of Nursing Publications

It has been known that activation of the central innate immune system or exposure to stress can disrupt balance of anti-/proinflammatory cytokines. The aim of the present study was to investigate the role of pro- and anti-inflammatory cytokines in the modulation of depressive-like behaviors, the hormonal and neurotransmitter systems in rats. We investigated whether centrally administered IL-1β is associated with activation of CNS inflammatory pathways and behavioral changes and whether treatment with IL-4 could modulate IL-1β-induced depressive-like behaviors and central neurotransmitter systems. Infusion of IL-4 significantly decreased IL-1β-induced anhedonic responses and increased social exploration and …

Randomized Sham Controlled Trial Of Cranial Microcurrent Stimulation For Symptoms Of Depression, Anxiety, Pain, Fatigue And Sleep Disturbances In Women Receiving Chemotherapy For Early-Stage Breast Cancer, Debra Lyon, Debra Kelley, Jeanne M. Walter, Harry Bear, Leroy R. Thacker, R.K. Elswick

School of Nursing Publications

Purpose

Women with breast cancer may experience symptoms of depression, anxiety, pain, fatigue and sleep disturbances during chemotherapy. However, there are few modalities that address multiple, commonly occurring symptoms that may occur in individuals receiving cancer treatment. Cranial electrical stimulation (CES) is a treatment that is FDA cleared for depression, anxiety and insomnia. CES is applied via electrodes placed on the ear that deliver pulsed, low amplitude electrical current to the head.

Methods

This phase III randomized, sham-controlled study aimed to examine the effects of cranial microcurrent stimulation on symptoms of depression, anxiety, pain, fatigue, and sleep disturbances in women …

Virginia Commonwealth University Volunteer Doula Program Training Manual, Kathleen M. Bell, Susan L. Linder

School of Nursing Publications

A birth doula is a specially trained birth assistant who provides emotional, psychological and physical support and care to a pregnant and/or laboring woman. In providing this care, the doula helps the laboring woman and her support person achieve their most optimal birth experience. This is typically an unmedicated birth; however, doulas may attend any birth and be of profound assistance and comfort.

This curriculum was written specifically for nursing students who are being trained as lay doulas. Unique in its approach and delivery, the curriculum is written with the nursing student in mind; particularly a student who has already …

Guided Imagery For Stress And Symptom Management In Pregnant African American Women, Nancy Jallo, R. Jeanne Ruiz, R. K. Elswick Jr., Elise French

School of Nursing Publications

The purpose of this study was to evaluate the efficacy of a guided imagery (GI) intervention for stress reduction in pregnant African American women beginning early in the second trimester. This prospective longitudinal study of 72 women used a randomized controlled experimental design with two groups conducted over 12 weeks. The intervention was a CD with 4 professionally recorded tracts designed and sequenced to influence study variables. Participants in both GI and usual care (UC) completed measures and donated 5 cc of blood at baseline, 8 weeks and 12 weeks. Participants also completed a daily stress scale. A mixed-effects linear …

Mindfulness: An Effective Coaching Tool For Improving Physical And Mental Health, Jo Lynne W. Robins, Laura G. Kiken, Melissa Holt, Nancy L. Mccain

School of Nursing Publications

Conscious attention to the present moment in a receptive way is known as mindfulness. A growing body of research indicates that mindfulness can be taught and cultivated to improve physical and mental health. Accordingly, as part of the coaching competency, mindfulness can be practiced and taught by advanced practice nurses to support lifestyle and behavioral changes, decrease perceived stress, enhance quality of life, and, ultimately, improve health and health outcomes. This article provides an overview of the mechanisms of action, evidence base, and practice of mindfulness, with an emphasis on how to easily incorporate this valuable skill into practice.

Optimizing Safe, Comfortable Icu Care Through Multi-Professional Quality Improvement: Just Do It, Alison J. Montpetit, Curtis N. Sessler

School of Nursing Publications

Translating research to the bedside can present significant challenges in the complex ICU environment. In this issue of Critical Care, de Jong and colleagues report on a quality improvement project (NURSE-DO) that led to a decrease in severe pain and serious adverse events during nursing care procedures in their ICU. In this commentary we describe three aspects of this quality improvement study that we think contributed to the overall success of the NURSE-DO project: the hospital environment and culture; multi-professional partnerships; and an evidence-based structured approach.

Epigenetics In Research And Practice, Debra E. Lyon, Susan G. Dorsey, Leorey Saligan

School of Nursing Publications

This special issue focused on the intersection of epigenetics with nursing research and practice. The first paper in this series addresses the role of epigenetic modifications in pain and analgesia response, highlighting the need for future research on epigenomic modification in the development of chronic pain, and summarizes the therapeutic potential to alter epigenetic processes to improve health outcomes. The second studies the epigenetic alterations and an increased frequency of micronuclei in women with fibromyalgia, highlighting a difference in an epigenetic biomarker in participants versus controls. The third paper explored the role of epigenetics in critical illness and the need …

Major Depressive Disorder And Measures Of Cellular Aging: An Integrative Review, Patricia Anne Kinser, Debra E. Lyon

School of Nursing Publications

Major depressive disorder (MDD) affects millions of individuals and causes significant suffering worldwide. It has been speculated that MDD is associated with accelerated aging-related biological and functional decline. To examine the accelerated aging hypothesis, one of the biomarkers under study is leukocyte telomeres, and specifically the measure of telomere length and telomerase activity. This review integrates findings from eleven human studies which evaluated telomere length and telomerase activity, in order to synthesize the state of the current science and to inform the development of new knowledge and enhance nursing research of depression using appropriate biobehavioral measures. Although preliminary, the findings …

Recruiting For Epigenetic Research: Facilitating The Informed Consent Process, Nancy Jallo, Debra E. Lyon, Patricia Anne Kinser, Debra Lynch Kelly, Victoria Menzies, Colleen Jackson-Cook

School of Nursing Publications

Because the effects of epigenetic (gene-environment interaction) changes have been associated with numerous adverse health states, the study of epigenetic measures provides exciting research opportunities for biobehavioral scientists. However, recruitment for studies focusing on any aspect of genetics poses challenges. Multiple factors, including lack of knowledge regarding a research study, have been identified as barriers to recruitment. Strengthening the informed consent process through extended discussion has been found to be effective in recruiting for research studies in general, yet there is a paucity of information that focused on such a recruitment strategy for epigenetic studies. In this paper, we share …

Psychoneuroimmunology-Based Stress Management During Adjuvant Chemotherapy For Early Breast Cancer, Jo Lynne W. Robins, Nancy L. Mccain, R. K. Elswick Jr., Jeanne M. Walter, D. Patricia Gray, Inez Tuck

School of Nursing Publications

Objective. In a randomized trial of women with early stage breast cancer undergoing adjuvant chemotherapy, two stress management interventions, tai chi training and spiritual growth groups, were compared to a usual care control group, to evaluate psychosocial functioning, quality of life (QOL), and biological markers thought to reflect cancer- and treatment-specific mechanisms. Method. The sample consisted of 145 women aged 27–75 years; 75% were Caucasian and 25% African American. A total of 109 participants completed the study, yielding a 75% retention rate. Grounded in a psychoneuroimmunology framework, the overarching hypothesis was that both interventions would reduce perceived stress, enhance QOL …

Control Group Design: Enhancing Rigor In Research Of Mind-Body Therapies For Depression, Patricia Anne Kinser, Jo Lynne W. Robins

School of Nursing Publications

Although a growing body of research suggests that mind-body therapies may be appropriate to integrate into the treatment of depression, studies consistently lack methodological sophistication particularly in the area of control groups. In order to better understand the relationship between control group selection and methodological rigor, we provide a brief review of the literature on control group design in yoga and tai chi studies for depression, and we discuss challenges we have faced in the design of control groups for our recent clinical trials of these mind-body complementary therapies for women with depression. To address the multiple challenges of research …

Epigenetic Alterations And An Increased Frequency Of Micronuclei In Women With Fibromyalgia, Victoria Menzies, Debra E. Lyon, Kellie J. Archer, Kimberly Jones, Guimin Gao, Timothy P. York, Colleen Jackson-Cook

School of Nursing Publications

Fibromyalgia (FM), characterized by chronic widespread pain, fatigue, and cognitive/mood disturbances, leads to reduced workplace productivity and increased healthcare expenses. To determine if acquired epigenetic/genetic changes are associated with FM, we compared the frequency of spontaneously occurring micronuclei (MN) and genome-wide methylation patterns in women with FM () to those seen in comparably aged healthy controls ( (MN); (methylation)). The mean (sd) MN frequency of women with FM (51.4 (21.9)) was significantly higher than that of controls (15.8 (8.5)) (; df = 1; ). Significant differences ( sites) in methylation patterns were observed between cases and controls considering a 5% …

Comparison Of Biomarkers In Blood And Saliva In Healthy Adults, Sarah Williamson, Cindy Munro, Rita Pickler, Mary Jo Grap, R. K. Elswick Jr.

School of Nursing Publications

Researchers measure biomarkers as a reflection of patient health status or intervention outcomes. While blood is generally regarded as the best body fluid for evaluation of systemic processes, substitution of saliva samples for blood would be less invasive and more convenient. The concentration of specific biomarkers may differ between blood and saliva. The objective of this study was to compare multiple biomarkers (27 cytokines) in plasma samples, passive drool saliva samples, and filter paper saliva samples in 50 healthy adults. Demographic data and three samples were obtained from each subject: saliva collected on filter paper over 1 minute, saliva collected …

Toothbrush Contamination: A Review Of The Literature, Michelle R. Frazelle, Cindy L. Munro

School of Nursing Publications

Toothbrushes are commonly used in hospital settings and may harbor potentially harmful microorganisms. A peer-reviewed literature review was conducted to evaluate the cumulative state of knowledge related to toothbrush contamination and its possible role in disease transmission. A systematic review was conducted on adult human subjects through three distinct searches. The review resulted in seven experimental and three descriptive studies which identified multiple concepts related to toothbrush contamination to include contamination, methods for decontamination, storage, design, and environmental factors. The selected studies found that toothbrushes of healthy and oral diseased adults become contaminated with pathogenic bacteria from the dental plaque, …

Challenges And Benefits Of Using A Virtual Community To Explore Nursing Concepts Among Baccalaureate Nursing Students, Linnea L. Carlson-Sabelli, Jean F. Giddens, Louis Fogg, Ruth A. Fiedler

School of Nursing Publications

This research study examines learner perceptions of benefits and challenges associated with the Neighborhood (NBH), an innovative pedagogy that fosters learner engagement and integration of nursing concepts using a “virtual community” as an alternative to lecture. First-semester students from five baccalaureate nursing programs that used the NBH intervention were divided into high (N = 78) and low faculty use (N = 203) groups. Qualitative analysis revealed that the NBH intervention promoted application of concepts to real life situation was engaging and “eye-opening,” allowing students to understand health care issues from a variety of perspectives. A major challenge was busy work …

Tryptophan Degradation In Women With Breast Cancer: A Pilot Study, Debra E. Lyon, Jeanne M. Walter, Angela R. Starkweather, Christine M. Schubert, Nancy L. Mccain

School of Nursing Publications

Background

Altered tryptophan metabolism and indoleamine 2,3-dioxygenase activity are linked to cancer development and progression. In addition, these biological factors have been associated with the development and severity of neuropsychiatric syndromes, including major depressive disorder. However, this biological mechanism associated with both poor disease outcomes and adverse neuropsychiatric symptoms has received little attention in women with breast cancer. Therefore, a pilot study was undertaken to compare levels of tryptophan and other proteins involved in tryptophan degradation in women with breast cancer to women without cancer, and secondarily, to examine levels in women with breast caner over the course of chemotherapy. …

Increased Interleukin-6 Activity Associated With Painful Chemotherapy-Induced Peripheral Neuropathy In Women After Breast Cancer Treatment, Angela R. Starkweather

School of Nursing Publications

Accumulating evidence suggests that neural-immune interactions are involved in the development of painful chemotherapy-induced peripheral neuropathy, particularly through the increased release of proinflammatory cytokines. The purpose of this study was used to evaluate levels of interleukin [IL]-6 and IL-6 receptors in women with breast cancer after the conclusion of chemotherapy who either had painful symptoms of chemotherapy-induced peripheral neuropathy (CIPN group, ) or did not experience CIPN symptoms (Comparison group, ). CIPN participants had significantly higher levels of IL-6 and soluble IL-6R (sIL-6R) compared to women without CIPN symptoms ( for both). In addition, soluble gp130, which blocks the IL-6/sIL-6R …