Nursing Commons^™

Pain In Parkinson’S Disease: Characteristics And Responses In Ambulatory Care Patients, Lisette Bunting-Perry

Lisette K Bunting-Perry

Pain is often a disabling symptom in Parkinson’s disease (PD), and is currently underassessed, underdiagnosed, and undertreated in this population of primarily older adults. Guided by the Rugh Model of Psychological Components of Pain, an exploration of the characteristics of pain experienced by individuals with PD, and the relationships among the emotional, cognitive, perceptual, and behavioral aspects of pain was undertaken. A convenience sample of 125 patients with PD reporting average daily pain as 2 or greater on the Brief Pain Inventory-Short Form, were recruited for a cross-sectional descriptive survey from two large urban movement disorder centers. Multiple measures were …

Impact Study Of A Central Lines Simulation Training Program Using Kirkpatrick’S Four-Level Evaluation Model, James P. Orlando Edd, Andrew C. Miller Do, William Bond Md, Ms, Valerie A. Rupp Rn, Bsn, Bryan G. Kane Md, Cindy Umbrell Rn, Msn, Michael Pasquale Md

Bryan G Kane MD

No abstract provided.

Impact Of An Interprofessional Central Venous Catheter Insertion Training Program, James P. Orlando Edd, Andrew Miller Do, William Bond Md, Ms, Valerie A. Rupp Rn, Bsn, Bryan G. Kane Md, Cindy Umbrell Rn, Msn, Michael Pasquale Md, Elizabeth Verheggen Phd, Elliot J. Sussman Md, Mba

Bryan G Kane MD

No abstract provided.

Maternal Mortality: The Need To Work With Traditional Birth Attendants To Offset The Problem, Nat Quansah

Nat Quansah

The Reninjaza (Traditional Birth Attendant) is recognized as the professional of Traditional Medicine specializing in the provision of maternal and infant health care services just as the Midwife is recognized as the professional of Allopathic Medicine who specializes in the provision of maternal and infant health care services. Having these professionals of the two medical systems work in a complimentary manner, it is argued, will not only result in improving the gathering of information on maternal deaths, the accuracy of reporting and monitoring of maternal deaths but more importantly, will result in the reduction of maternal deaths. This is because …

Immersion Research Education: Students As Catalysts For International Collaboration Research, Kathryn H. Anderson, Marie-Luise Friedemann, Andreas Buescher, Julita Sansoni, Donna R. Hodnicki

Kathryn H. Anderson

Background:  This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research. Aim:  To narrow the healthcare gap for disadvantaged families in the USA and partner countries. Methods:  Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA students in the …

Refinement Of The Shared Care Instrument-Revised: A Measure Of A Family Care Interaction, Margaret Sebern

Margaret Sebern

This study’s purpose was to evaluate the psychometric properties of the Shared Care Instrument-Revised (SCI-R) in a sample of family care dyads. The SCI-R was developed to measure the construct of shared care, which is a system of three constructs (communication, decision making, reciprocity) used in family care to exchange support. An important aspect of evaluating the SCI-R was to create a measure that is statistically sound and meaningful for patient and caregivers. Surveys were mailed to randomly selected home health dyads, which included 223 patients and 220 caregivers. Reliability and confirmatory factor analysis, and concurrent validity were examined. Internal …

Explication Of The Construct Of Shared Care And The Prevention Of Pressure Ulcers In Home Health Care, Margaret Sebern

Margaret Sebern

The purpose of this investigation was to render a more complete understanding of subjective perceptions of pressure ulcers from the perspective of family dyads, and to study the effect of these subjective experiences on preventive behaviors and pressure ulcer outcomes. A naturalistic inquiry, combined with objective measures, was used. Twenty-one dyads participated in four in-depth interviews to explore how they mentally represented and responded to the risk of pressure ulcers. Through the process of concept development, a lay representation of pressure ulcers was developed. This process produced a new concept, identified as “shared care,” that explained how the dyads interaction …

Shared Care, Elder And Family Member Skills Used To Manage Burden, Margaret Sebern

Margaret Sebern

Aim. The aim of this paper is to further develop the construct of Shared Care by comparing and contrasting it to related research, and to show how the construct can be used to guide research and practice. Background. While researchers have identified negative outcomes for family caregivers caused by providing care, less is known about positive aspects of family care for both members of a family dyad. Understanding family care relationships is important to nurses because family participation in the care of chronically ill elders is necessary to achieve optimal outcomes from nursing interventions. A previous naturalistic inquiry identified a …

Technology-Enhanced Practice For Patients With Chronic Cardiac Disease: Home Implementation And Evaluation, Patricia Flatley Brennan, Gail Casper, Laura Burke, Kathy Johnson, Roger L. Brown, Rupa Valdez, Margaret Sebern, Oscar Perez, Billie Sturgeon

Margaret Sebern

Objective: This 3-year field experiment engaged 60 nurses and 282 patients in the design and evaluation of an innovative home-care nursing model, referred to as technology-enhanced practice (TEP). Methods: Nurses using TEP augmented the usual care with a web-based resource (HeartCareII) that provided patients with self-management information, self-monitoring tools, and messaging services. Results: Patients exposed to TEP demonstrated better quality of life and self-management of chronic heart disease during the first 4 weeks, and were no more likely than patients in usual care to make unplanned visits to a clinician or hospital. Both groups demonstrated the same long-term symptom management …

Dyadic Relationship Scale: A Measure Of The Impact Of The Provision And Receipt Of Family Care, Margaret Sebern, Carol J. Whitlatch

Margaret Sebern

Purpose: This study evaluated the psychometric properties of the Dyadic Relationship Scale (DRS), which measures negative and positive dyadic interactions from the perspective of both the patient and the family caregiver. An important aspect of evaluating the DRS was that it be statistically sound and meaningful for both members of the dyad. Design and Methods: The study used a cross-sectional design. Survey packages were mailed to home health care patients and their family caregivers. The unit of analysis was the dyad, and exploratory and confirmatory factor analyses were conducted. We examined the reliability, discriminant, and concurrent validities of the instrument. …

Psychometric Testing Of The Self-Care Of Heart Failure Index, Barbara Riegel, Beverly Carlson, Debra K. Moser, Margaret Sebern, Frank D. Hicks, Virginia Roland

Margaret Sebern

Background: Self-care is believed to improve outcomes in heart failure (HF) patients. However, research testing this assumption is hampered by difficulties in measuring self-care. The purpose of this study was to evaluate the psychometric properties of a revised instrument measuring self-care in persons with HF, the Self-Care of Heart Failure Index (SCHFI). The SCHFI is a self-report measure comprised of 15 items rated on a 4-point response scale and divided into 3 subscales. Methods and Results: Psychometric testing was done using data from 760 HF patients (age 70.36 ± 12.3 years, 51% male) from 7 sites in the United States. …

Shared Care Dyadic Intervention: Outcome Patterns For Heart Failure Care Partners, Margaret Sebern, Aimee Woda

Margaret Sebern

Up to half of heart failure (HF) patients are readmitted to hospitals within 6 months of discharge. Many readmissions are linked to inadequate self-care or family support. To improve care, practitioners may need to intervene with both the HF patient and family caregiver. Despite the recognition that family interventions improve patient outcomes, there is a lack of evidence to support dyadic interventions in HF. Thus, the purpose of this study was to test the Shared Care Dyadic Intervention (SCDI) designed to improve self-care in HF. The theoretical base of the SCDI was a construct called Shared Care. Shared Care represents …

The Effect Of Education On Rehabilitation Nursing Staff Knowledge, Kristen L. Mauk

Kristen L. Mauk

Rehabilitation is a specialty area with defined competencies and discrete nursing knowledge. Unless nurses have been educated in the basic competencies of rehabilitation, they are not prepared to provide safe, quality rehabilitative care to patients with chronic illnesses and disabilities. An evidence-based practice project was designed to address the need for education of the nursing staff working on an inpatient rehabilitation unit in Northwest Indiana. Roger's Diffusion of Innovations provided the theoretical framework for the project. A critical appraisal of the literature was conducted to determine best practice. The literature showed that education increased knowledge in a specialty area, and …

Hiv Testing Behaviors Of A Cohort Of Hiv-Positive Racial/Ethnic Minority Ymsm, Sheldon Fields

Sheldon D. Fields

The HIV epidemic in the United States has disproportionately affected young racial/ethnic minority men who have sex with men (YMSM). However, HIV testing rates among young men of color remain low. Within this sample of racial/ethnic minority YMSM (n = 363), the first HIV test was a median of 2 years after men who have sex with men sexual debut. Individuals with less than 1 year between their first negative and first positive HIV test were significantly more likely to identify the reason for their first negative test as being sick (OR = 2.99; 95 % CI 1.23-7.27). This may …

Patterns Of Hiv Disclosure And Condom Use Among Hiv-Infected Young Racial/Ethnic Minority Men Who Have Sex With Men., Sheldon Fields

Sheldon D. Fields

Recent findings highlight the continued rise in cases of HIV infection among racial/ethnic minority young men who have sex with men (YMSM). In adults, disclosure of HIV status has been associated with decreased sexual risk behaviors but this has not been explored among YMSM. In this study of 362 HIV-infected racial/ethnic minority YMSM, rates of disclosure were high, with almost all disclosing their status to at least one person at baseline. The majority had disclosed to a family member, with higher disclosure rates to female relatives compared with males. After adjustment for site, disclosure to sex partners and boyfriends was …

Platelet-Derived Growth Factor Receptor-Alpha-Expressing Cells Localize To The Alveolar Entry Ring And Have Characteristics Of Myofibroblasts During Pulmonary Alveolar Septal Formation, Stephen E. Mcgowan, Ruth E. Grossmann, Patricia Kimani, Amey J. Holmes

Ruth E. Grossmann

Platelet-derived growth factor-A and its receptor, platelet-derived growth factor receptor-alpha (PDGF-Rα), are required for formation of the secondary pulmonary alveolar septa in mice. However, it remains unclear how these molecules direct the secondary septation process. We have examined the abundance, location, and the accumulation of alpha-smooth muscle actin (αSMA), neutral lipid droplets, and elastin in the proximity of PDGF-Rα-expressing alveolar cells during postnatal days 4 through 12 in the mouse. PDGF-Rα-expressing cells preferentially have characteristics of myofibroblasts and were more likely to contain αSMA than are alveolar cells that do not express PDGF-Rα. PDGF-Rα expressing cells were preferentially located in …

Researcher And Institutional Review Board Chair Perspectives On Incidental Findings In Genomic Research, Janet K. Williams, Sandra Daack-Hirsch, Martha Driessnack, Nancy R. Downing, L. Shinkunas, D. Brandt, C. Simon

Nancy R Downing

Aims: Genomic research can produce findings unrelated to a study's aims. The purpose of this study was to examine researcher and Institutional Review Board (IRB) chair perspectives on genomic incidental findings (GIFs). Methods: Nineteen genomic researchers and 34 IRB chairs from 42 institutions participated in semi-structured telephone interviews. Researchers and chairs described GIFs within their respective roles. Few had direct experience with disclosure of GIFs. Researchers favored policies where a case by case determination regarding whether GIF disclosure would be offered after discovery, whereas IRB chairs preferred policies where procedures for disclosure would be determined prior to approval of the …

Couples' Illness Representation And Coping Procedures In Prodromal Huntington Disease, Nancy Ruth Downing

Nancy R Downing

Huntington disease (HD) is a degenerative neurological disease that typically onsets in midlife. It leads to progressively severe impairment in cognitive, behavioral, and motor function and premature death. Persons who test positive for the HD gene expansion know they will develop the disease. Research indicates changes are detectable several years before onset. Thus, HD has a long prodromal period (prHD). While researchers are aware of changes, little is known whether persons with prHD or their companions notice changes, or how they make sense of and cope with them. Leventhal and colleagues developed the Common Sense Model of Illness Representation (CSM) …

Hospital Governance In Latin America: Results From A Four Nation Survey, Richard J. Bogue, Claude H. Hall, Gerard M. La Forgia

Richard J Bogue

The objective of this research was to identify types of hospital governance in Latin America and to examine whether and how these governance types are associated with hospital performance. The authors also sought to explore hospital governance conceptually and contextually within national and international experience. The research was based on survey of nearly 400 hospitals in Argentina, Brazil, Colombia and Mexico. The authors conducted a cluster analysis of the results identifying four governance types based on organizational elements theorized to affect hospital behavior: (1) budgetary unit of government; (2) autonomous unit of government; (3) corporate unit of a private conglomerate …

Nursing Students Participate In First Annual Blessing Of The Hands, Kim Foito

Kim Foito

“The onset of the clinical experience is a milestone. The nursing faculty at Sacred Heart recognizes the value of spirituality. We planned this celebration to embody the great significance our hands represent in healing” --Kim Foito, clinical assistant professor of Nursing.

Path Tortuosity In Everyday Movements Of Elderly Persons Increases Fall Prediction Beyond Knowledge Of Fall History, Medication Use, And Standardized Gait And Balance Assessments., William D. Kearns Phd, James L. Fozard Phd, Marion Becker Rn/Phd, Jan M. Jasiewicz Phd, Jeffrey D. Craighead Phd, Lori Holtsclaw Ba, Charles Dion Ma

William D. Kearns, PhD

Abstract Objectives: We hypothesized that variability in voluntary movement paths of assisted living facility (ALF) residents would be greater in the week preceding a fall compared with residents who did not fall. Design: Prospective, observational study using telesurveillance technology. Setting: Two ALFs. Participants: The sample consisted of 69 older ALF residents (53 female) aged 76.9 (SD=11.9 years). Measurement: Daytime movement in ALF common use areas was automatically tracked using a commercially available ultra-wideband radio real-time location sensor network with a spatial resolution of approximately 20 cm. Movement path variability (tortuosity) was gauged using fractal dimension (fractal D). A logistic regressionwas …

Standardized Query Formatting, Joyce K. Kutin

Joyce K Kutin RN, MSN, MOL

Evolving more than thirty years ago, the Diagnosis Related Groups (DRGs) covers a wide variety of applications that impact all health care segments throughout the United States. The DRGs are a patient classification scheme originally developed as a means of relating the type of patients a hospital treats (i.e., casemix) to the costs incurred by the hospitals.

The DRG terminology has experienced evolutionary growth through later generations: Major Comorbidities and Complications (MCC), Comorbidities and Complications (CC) and All Patient Refined Diagnosis Related Groups (APR DRG). This process directly impacts the reimbursement or payment re-distribution by Medicare and Medicaid.

Medicare continues …

Sex Work In Trucking Milieux: ‘Lot Lizards,’ Truckers, And Risk, Yorghos Apostolopoulos, Sevil Sönmez, Mona Shattell, Jennifer Kronenfeld

Mona Shattell

No abstract provided.

Trucking Organization And Mental Health Disorders Of Truck Drivers, Mona Shattell, Yorghos Apostolopoulos, Chad Collins, Sevil Sonmez, Caitlin Fehrenhacher

Mona Shattell

Background: There are over 3 million truck drivers employed in the commercial transportation and material moving occupations, one of the largest occupational groups in the United States. Workers in this large and growing occupational segment are at risk for a range of occupational health-induced conditions including mental health and psychiatric disorders due to high occupational stress, low access and use of health care, and limited social support.

Objective: The purpose of the study was to explore male truck drivers’ mental health risks and associated co-morbidities, using a cross-sectional and quantitative design.

Methods and Sample: Data were collected from a random …

Exploring Barriers To Organ Donation In The African American Communities Of California, D. R. Law, Susan Mcniesh

Susan McNiesh

There are a disproportionate number of African-Americans on transplant waiting lists across the country. The outcomes of a transplant are greatly improved when the donor and the recipient are from the same ethnic group. Sadly, the demand for cadaver organs in the African-American community exceeds the supply. Researchers in the past have sought to identify barriers to organ and tissue donation. To date, the studies have been conducted in the eastern and southern regions of the United States. This study examines whether the previously identified barriers are applicable in the African-American communities of California. A revised version of the Bone …

Mortalidade Materna No Paraná: O Que Mostra A Produção Científica Nos Últimos 10 Anos? / Maternal Mortality In Paraná: Showing The Scientific Production In The Last 10 Years?, Everton Fernando Alves, Thais Abigail Vidoto

Everton Fernando Alves

A mortalidade materna atrai inúmeras discussões e preocupações no Paraná visto que reflete a qualidade da assistência prestada nos serviços de saúde, bem como a operacionalização das políticas públicas voltadas à saúde da mulher. O objetivo deste trabalho foi conhecer o perfil epidemiológico da mortalidade materna no Estado do Paraná, por meio de revisão de estudos sobre o tema. Trata-se de uma revisão sistemática da literatura, realizada através da busca eletrônica de artigos científicos publicados entre 2000 e 2010, nas bases de dados LILACS e SciELO. Identificaram-se inicialmente 30 artigos. Após aplicação dos critérios de inclusão e exclusão restaram 09 …

Hepatitis C Screening And Testing: A Call For A National Response., Donna M. Zucker Rn, Phd, Faan

Donna M. Zucker

The purpose of this brief is to convey the immediate need to coordinate and integrate hepatitis C virus (HCV) screening and testing for HIV co-infected and HCV infected clients, into primary care. In 2000, 1.25 million persons were estimated to be chronically infected with hepatitis B virus (HBV), and 2.7 million are chronically infected with HCV. Furthermore, 55% to 85% of new HCV infections become chronic. Of the 1.0 million people chronically infected with HIV, 250,000 also have HBV, and ~50,000 also have HCV, the leading cause of hepatocellular carcinoma. Liver disease is now the leading cause of death in …

The Impact Of Maternal Smoking During Pregnancy On Early Child Neurodevelopment, G. L. Wehby, K. Prater, Anne Marie Mccarthy, E. E. Castilla, J. C. Murray

Ann Marie McCarthy

Early child neurodevelopment has major impacts on future human capital and health. However, not much is known about the impacts of prenatal risk factors on child neurodevelopment. This study evaluates the effects of maternal smoking during pregnancy on child neurodevelopment between 3 and 24 months of age and interactions with socioeconomic status (SES). Data from a unique sample of children from South America are employed. Smoking has large adverse effects on neurodevelopment, with larger effects in the low SES sample. The study results highlight the importance of early interventions beginning before and during pregnancy for enhancing child development and future …

Researcher And Institutional Review Board Chair Perspectives On Incidental Findings In Genomic Research, Janet K. Williams, Sandra Daack-Hirsch, Martha Driessnack, Nancy R. Downing, L. Shinkunas, D. Brandt, C. Simon

Janet K. Williams

Aims: Genomic research can produce findings unrelated to a study's aims. The purpose of this study was to examine researcher and Institutional Review Board (IRB) chair perspectives on genomic incidental findings (GIFs). Methods: Nineteen genomic researchers and 34 IRB chairs from 42 institutions participated in semi-structured telephone interviews. Researchers and chairs described GIFs within their respective roles. Few had direct experience with disclosure of GIFs. Researchers favored policies where a case by case determination regarding whether GIF disclosure would be offered after discovery, whereas IRB chairs preferred policies where procedures for disclosure would be determined prior to approval of the …

Women With Knee Osteoarthritis Have More Pain And Poorer Function Than Men, But Similar Physical Activity Prior To Total Knee Replacement, S. M. Tonelli, Barbara A. Rakel, N. A. Cooper, W. L. Angstom, K. A. Sluka

Barbara A. Rakel

ABSTRACT: BACKGROUND: Osteoarthritis of the knee is a major clinical problem affecting a greater proportion of women than men. Women generally report higher pain intensity at rest and greater perceived functional deficits than men. Women also perform worse than men on function measures such as the 6-minute walk and timed up and go tests. Differences in pain sensitivity, pain during function, psychosocial variables, and physical activity levels are unclear. Further the ability of various biopsychosocial variables to explain physical activity, function and pain is unknown. METHODS: This study examined differences in pain, pain sensitivity, function, psychosocial variables, and physical activity …