Medicine and Health Sciences Commons^™

Sleeplessness, Deborah Schoenfelder, Keela Herr

Deborah P. Schoenfelder

This article identifies and reviews research related to sleeplessness reported by nurses in the literature. The current state of clinical nursing research as it relates to sleep is evaluated, including the content, methodology, and implications for further research. Although the review indicates current interest in sleep by clinical nurse researchers, the number of nursing studies in the literature is limited, especially within specific areas, such as age groups and setting. Also, directions for future nursing research on sleep are recommended.

An Exercise Program To Improve Fall-Related Outcomes In Elderly Nursing Home Residents, Deborah Schoenfelder, L. Rubenstein

Deborah P. Schoenfelder

This study tested a 3-month ankle-strengthening and walking program designed to improve or maintain the fall-related outcomes of balance, ankle strength, walking speed, risk of falling, fear of falling, and confidence to perform daily activities without falling (falls efficacy) in elderly nursing home residents. Nursing home residents (N = 81) between the ages of 64 and 100 years participated in the study. Two of the fall-related outcomes, balance and fear of falling, were maintained or improved for the exercise group in comparison to the control group.

A Fall Prevention Educational Program For Community Dwelling Seniors, Deborah Schoenfelder, K. Van Why

Deborah P. Schoenfelder

The purpose of this research was to assess participants' responses to a fall prevention educational program. Fourteen persons volunteered to participate in the study conducted at a large senior center. Descriptive statistics were used to characterize the sample and to assess subjects' awareness about falls, attitudes about fall risk, fall prevention behaviors, and incidence of falls before the fall prevention program and again at one month and three months after the program. Forty-six percent of the sample had fallen in the previous year. In general, subjects' perceptions that their risk of falling was lower than others of the same age …

Work Restrictions: Documenting A Patient's Return To Work, Kerri Rupe

Kerri A. Rupe

Patients frequently ask NPs to write work restrictions, even if it is not in their best interest. This article helps providers construct valid work restrictions and addresses specific tasks and issues to keep the patient and coworkers safe when returning to work.

Nurses' Perception Of Their Manager's Leadership Style And Unit Climate: Are There Generational Differences?, Amany Farag, S. Tullai-Mcguinness, M. Anthony

Amany A. Farag

AIM: To describe and compare how nurses representing four age cohorts perceive their manager's leadership style and unit climate. BACKGROUND: The current workforce consists of nurses representing four generational cohorts. Nursing literature suggests that nurses from each age cohort think, behave and approach work differently. Limited empirical evidence, however, exists about how nurses from each age cohort perceive two aspects of their work environment: their managers' leadership style and unit climate. METHOD: This cross-sectional, descriptive survey was conducted using a convenience sample of 475 registered nurses working in different inpatient units in three community non-magnet hospitals. RESULTS AND CONCLUSION: Only …

Perceived Stress In Prodromal Huntington Disease, Nancy Downing, M. Smith, L. Beglinger, J. Mills, K. Duff, K. Rowe, E. Epping, J. Paulsen, Group Predict-Hd Investigators Of Huntington Study

Nancy R Downing

This study examines perceived stress and its relationship to depressive symptoms, life changes and functional capacity in a large sample of individuals who are positive for the Huntington disease (HD) gene expansion but not yet diagnosed. Participants were classified by estimated proximity to HD diagnosis (far, mid, near) and compared with a non-gene-expanded comparison group. Persons in the mid group had the highest stress scores. A significant interaction between age and time since HD genetic testing was also found. Secondary analyses using data from a different data collection point and including a diagnosed group showed the highest stress scores in …

Developing Strategic Interventions To Reduce Cardiovascular Disease Risk Among Law Enforcement Officers: The Art And Science Of Data Triangulation, Sandra Ramey, Nancy Downing, A. Knoblauch

Nancy R Downing

The purpose of this study was to use data triangulation to inform interventions targeted at reducing morbidity from cardiovascular disease (CVD) and associated risk factors among law enforcement officers. Using the Precede-Proceed Health Promotion Planning Model, survey data (n = 672) and focus group data (n = 8 groups) from the Milwaukee Police Department were analyzed. Narrative transcripts disclosed that law enforcement officers encounter potential barriers and motivators to a healthy lifestyle. Survey results indicated rates of overweight (71.1% vs. 60.8%) and hypertension (27.4% vs. 17.6%) were significantly (p < or = .001) higher among Milwaukee Police Department law enforcement officers than the general population of Wisconsin (n = 2,855). The best predictor of CVD was diabetes (p = .030). Occupational health nurses are uniquely positioned to identify health risks, design appropriate interventions, and advocate for policy changes that improve the health of those employed in law enforcement and other high-risk professions.

Milwaukee Police Department Retirees: Cardiovascular Disease Risk And Morbidity Among Aging Law Enforcement Officers, Sandra Ramey, Nancy Downing, W. Franke

Nancy R Downing

This study explored the self-reported prevalence of cardiovascular disease (CVD) and accompanying risk factors among 165 male retirees 43 years and older (M = 56.2, SD = 7.1) from the Milwaukee Police Department (MPD) compared to 671 individuals of similar age and income who responded to the 2005 Wisconsin Behavioral Risk Factor Surveillance System (BRFSS). CVD and other risk factors were more prevalent in the MPD retirees than the general population (CVD 15.2% vs. 9.5%, p = .036; hypertension 51.5% vs. 36.2%, p = .001; hypercholesterolemia 62.4% vs. 44.4%, p = .001; overweight and obesity 85.1% vs. 74.7%, p = …

The Disclosure Decisions Of Parents Who Conceive Children Using Donor Eggs, S. Hahn, Martha Craft-Rosenberg

Martha J. Craft-Rosenberg

STUDY OBJECTIVE: To identify variables that influence the disclosure decisions of parents who conceive children using donor eggs and to compare such variables among disclosing, nondisclosing, and undecided families. DESIGN: Exploratory, comparative, descriptive. SETTING: A university hospital-assisted reproductive technology program in the Midwest. PARTICIPANTS: Thirty-one couples with children conceived with anonymously donated eggs. METHODS: Audiotaped telephone interviews, measures of social support and family environment, and a demographic survey. MAIN OUTCOME MEASURES: Content analysis of interview transcripts and comparison of recurring themes among groups. RESULTS: The majority of parents intended disclosure. Dominant themes among disclosing parents included the belief that a …

Assessing Intimate Partner Violence In Incarcerated Women, M. Eliason, Janette Taylor, S. Arndt

Janette Y. Taylor

The purpose of this study to assess the psychometric qualities of a screening instrument for intimate partner violence, the Index of Spouse Abuse (ISA), for use with incarcerated women. Principal components factor analysis was conducted on data collected from 149 incarcerated women. The ISA demonstrated excellent internal consistency with this population and appears to be a psychometrically sound instrument that can be given in a short period of time.

Sisters Of The Yam: African American Women's Healing And Self-Recovery From Intimate Male Partner Violence, Janette Taylor

Janette Y. Taylor

In this womanist ethnographic investigation African American women (N = 21) survivors of intimate male partner violence were interviewed about their resilience-recovering experiences. This article foregrounds the role of therapeutic support groups in African American women's healing experience and addresses how race and ethnicity shape the lives and the recovering process for many African American women. The findings are important to practitioners who strive to provide assistance and interventions for African American women as well as other women of color.

No Resting Place: African American Women At The Crossroads Of Violence, Janette Taylor

Janette Y. Taylor

Seeking safe places after leaving abusive relationships is often an intricate process for African American women. Survivor-victims of gender violence frequently experience ongoing trauma because of race, ethnicity, class, sexual orientation, and other stigmatizing social identities. All too often, women of color must handle leaving the gender violence simultaneously with the ongoing threat of cultural violence. The intersection of gender and cultural violence (e.g., racism, discrimination) complicate African American women's ability to obtain and sustain safe environments. These intersections are critical crossroads in African American women's lives. The results of this womanist and Black feminist study are presented in an …

Moving From Surviving To Thriving: African American Women Recovering From Intimate Male Partner Abuse, Janette Taylor

Janette Y. Taylor

In this ethnographic study, a womanist framework was used to investigate the process of recovery from domestic violence. A purposive sample of African American women (N = 21) was interviewed to gain understanding of their recovery process. Survivorship-thriving was the overarching process. Six themes related to survivorship-thriving were identified: (a) Sharing secrets/Shattering silences--sharing information about the abuse with others; (b) Reclaiming the Self-defining oneself separate from abuser and society; (c) Renewing the Spirit-nurturing and restoring the spiritual and emotional self; (d) Self-healing through Forgiveness--forgiving their partners for the abuse and violence; (e) Finding inspiration in the Future-looking to the future …

Exploring Differences Between Community-Based Women And Men With A History Of Mental Illness, Cheryl Forchuk, Elsabeth Jensen, Rick Csiernik, Catherine Ward-Griffin, Susan Ray, Phyllis Montgomery, Linda Wan

Rick Csiernik

Relatively little is understood concerning the role of gender in persons with a history of mental illness residing in the community. This paper aims to explore gender's effect using data from the Community Research University Alliance project entitled, Mental Health and Housing. The primary five-year longitudinal study examined housing situations for psychiatric consumer/survivors in a mid-size, central Canadian region in an effort to improve the number and quality of appropriate housing situations. Data from 887 subjects in the original research underwent secondary analysis with particular relevance to differences between gender and indicators of health status including psychiatric history, levels of …

The Influence Of Cognitive-Perceptual Variables On Patterns Of Change Over Time In Rural Midlife And Older Women's Healthy Eating., Bernice C, Yates, Carol H. Pullen, Jonathan Bruce Santo, Linda Boeckner, Patricia A. Hageman, Paul J. Dizona, Susan Noble Walker

Journal Articles: College of Nursing

Although studies demonstrate that dietary interventions for healthy adults can result in beneficial dietary changes, few studies examine when and how people change in response to these interventions, particularly in rural populations. The purpose of this study was to examine patterns of change over time in healthy eating behaviors in midlife and older women in response to a one-year health-promoting intervention, and to examine what predictors (perceived benefits, barriers, self-efficacy, and family support for healthy eating) influence the changes during the intervention and follow-up. Data for this secondary analysis were from the Wellness for Women community-based trial. Women (N = …

Body Mass Index Misclassification Of Obesity Among Community Police Officers, M. Alasagheirin, M. Clark, Sandra Ramey, E. Grueskin

M. Kathleen Clark

Occupational health nurses are at the forefront of obesity assessment and intervention and must be aware of potential inaccuracies of obesity measurement. The purpose of this study was to identify the prevalence of obesity among a sample of 84 male police officers 22 to 63 years old and determine the accuracy of body mass index (BMI) in estimating obesity compared to body fat percent (BF %). BMI identified 39.3% of the participants as obese, compared to 70.2% by BF %. BMI misclassified normal-weight officers as obese or overweight and obese officers as normal 48.8% (n = 41) of the time. …

Effectiveness Of Transcutaneous Electrical Nerve Stimulation On Postoperative Pain With Movement, Barbara Rakel, Rita Frantz

Barbara A. Rakel

This study tested the effectiveness of episodic transcutaneous electrical nerve stimulation (TENS) as a supplement to pharmacologic analgesia on pain with movement and at rest after abdominal surgery and evaluated whether its use during walking and vital capacity maneuvers enhances performance of these activities. TENS, with a modulated frequency, intensity as high as the subject could tolerate, and electrodes placed on either side and parallel to the incision, was compared to placebo TENS and pharmacologic analgesia alone (control) by using a crossover design. Self-report of pain intensity, walking function, and vital capacity were assessed on 33 subjects. TENS resulted in …

Clinical Outcome Of Emergency Repeat Coronary Artery Bypass Surgery, J. Lemmer, D. Ferguson, Barbara Rakel, N. Rossi

Barbara A. Rakel

To determine the clinical outcome of patients requiring emergency repeat coronary artery bypass graft (CABG) procedures, we reviewed 23 such procedures performed for ongoing myocardial ischemia refractory to medical management. The operative mortality was 17%. On follow-up, an average of 24.9 months after emergency reoperation, 14 of the 19 survivors (74%) had recurrent angina. As compared to a randomly selected group of 25 patients who underwent elective repeat CABG procedures during the same time period, the incidence of late cardiac events was significantly higher (79% in the emergency group, 30% in the elective surgery group) and fewer patients had received …

Development Of Alterations In Learning: Situational Learning Disabilities, Barbara Rakel, G. Bulechek

Barbara A. Rakel

Until now the nursing diagnosis knowledge deficit has served as a label for all teaching/learning situations. This is inadequate and does not effectively give direction to correct intervention(s). The purpose of this article is to present the diagnostic concept, situational learning disability (SLD), a component of Alterations in Learning, which has been identified as an area to be developed in the Knowing pattern of the NANDA taxonomy. A thorough review of the literature and empirical support involving 20 cardiology patients on a 27-bed telemetry step-down unit is provided. The data support the development of two nursing diagnoses: (1) situational learning …

The Meaning Of Parenteral Hydration To Family Caregivers And Patients With Advanced Cancer Receiving Hospice Care., Marlene Z. Cohen, Isabel Torres-Vigil, Beth E. Burbach, Allison De La Rosa, Eduardo Bruera

Journal Articles: College of Nursing

CONTEXT: In the U.S., patients with advanced cancer who are dehydrated or have decreased oral intake almost always receive parenteral hydration in acute care facilities but rarely in the hospice setting.

OBJECTIVES: To describe the meaning of hydration for terminally ill cancer patients in home hospice care and for their primary caregivers.

METHODS: Phenomenological interviews were conducted at two time points with 85 patients and 84 caregivers enrolled in a randomized, double-blind, controlled trial examining the efficacy of parenteral hydration in patients with advanced cancer receiving hospice care in the southern U.S. Transcripts were analyzed hermeneutically by the interdisciplinary research …

Associations Of Cardiorespiratory Fitness And Fatness With Metabolic Syndrome In Rural Women With Prehypertension., Patricia A. Hageman, Carol H. Pullen, Melody A. Hertzog, Linda S. Boeckner, Susan Noble Walker

Journal Articles: Physical Therapy

BACKGROUND: This study investigated the associations of fitness and fatness with metabolic syndrome in rural women, part of a recognized US health disparities group.

METHODS: Fitness, percentage body fat, BMI, and metabolic syndrome criteria were assessed at baseline in 289 rural women with prehypertension, ages 40-69, enrolled in a healthy eating and activity community-based clinical trial for reducing blood pressure.

RESULTS: Ninety (31%) women had metabolic syndrome, of which 70% were obese by BMI (≥30 kg/m²), 100% by percentage body fat (≥30%), and 100% by revised BMI standards (≥25 kg/m²) cited in current literature. Hierarchical logistic regression models, adjusted for …