Nursing Commons^™

The Unique Needs Of Older Adults Readmitted To The Hospital, Laila Hasan, Maharaj Singh, Ariba Khan, John Lung, Michael Malone, Anna Karst

College of Nursing Faculty Research and Publications

Approximately 20% of Medicare beneficiaries are readmitted within 30 days of discharge from the hospital, costing $17.4 billion per year.1 A number of studies have examined the factors associated with risk of hospital readmissions.1 To the best of the knowledge of the authors of the current study, no studies have examined the characteristics of individuals who are on their second hospital stay. Identification of these characteristics is important for quality care, better interventions, and economic reasons.2 This study was performed to examine the characteristics and vulnerabilities of individuals aged 65 and older who had a second hospital stay within 30 …

Self-Assessed Health In Caregivers Of Persons With Autism: Associations With Depressive Symptoms, Positive Cognitions, Resourcefulness, And Well-Being, Abir K. Bekhet

College of Nursing Faculty Research and Publications

Purpose

Caregiving for children with autism spectrum disorder (ASD) can affect family caregivers' self-assessed health. The purpose of this study was to determine whether depressive symptoms, positive cognitions, resourcefulness, and well-being will differ significantly among those who rated their health as fair, good, or excellent.

Design and Methods

This study is a secondary analysis of 109 ASD caregivers who were recruited from the Interactive ASD Network.

Findings

Depression was significantly lower among those who rated their health as excellent than among those who rated their health as fair. Positive cognitions, resourcefulness, and well-being were significantly higher among those who rated …

A Comparison Of Two Formulas Of Topical Menthol On Vascular Responses And Perceived Intensity Prior To And Following A Bout Of Maximum Voluntary Muscular Contractions (Mvmcs), Robert V. Topp, Alexander V. Ng, Alyson Cybulski, Katalin W. Skelton, Paula E. Papanek

College of Nursing Faculty Research and Publications

The purpose of this study was to compare the vascular responses in the brachial artery and perceived intensity of two different formulas of topical menthol gels prior to and following a bout of maximum voluntary muscular contractions (MVMCs).

18 adults completed the same protocol on different days using blinded topical menthol gels (Old Formula and New Formula). Heart rate, brachial artery blood flow (ml/min), vessel diameter and reported intensity of sensation were measured at baseline (T1), at 5 min after application of the gel to the upper arm (T2), and immediately following five MVMCs hand grips (T3).

The New Formula …

Strategies For Sustaining Self Used By Family Caregivers For Older Adults With Dementia, Margaret J. Bull

College of Nursing Faculty Research and Publications

The negative health consequences of caring for an older adult family member with dementia are well documented. However, not all family caregivers experience these negative health consequences. The purposes of this study were to describe strategies family caregivers use to help them continue to provide care for an older family member with dementia despite challenges and describe these family caregivers’ resilience and psychological distress. A mixed methods design was used with a narrative approach dominant and standardized scales for resilience and psychological distress used to enhance the description of the sample. Data were collected through telephone interviews with 18 family …

Patient Perceptions Of Patient-Empowering Nurse Behaviours, Patient Activation And Functional Health Status In Postsurgical Patients With Life-Threatening Long-Term Illnesses, Teresa Jerofke-Owen, Marianne E. Weiss, Olga Yakusheva

College of Nursing Faculty Research and Publications

Aim

To explore the trajectory of associations between the nursing care process of patient empowerment during postsurgical hospitalization and postdischarge patient self-management outcomes, specifically patient activation and functional health status.

Background

Patient-centred care models advocate for patient empowerment in long-term illness care. Postsurgical patients with life-threatening long-term illnesses frequently feel powerless, have unmet needs, decreased functional health status and high readmission rates; however, previous studies of patient empowerment have conceptualized empowerment as an outcome primarily in outpatient settings, with little attention paid to provider processes used to empower patients during hospitalizations.

Design

A non-experimental, prospective, correlational study.

Methods

This sample …

Psychometric Properties Of The Index Of Relocation Adjustment, Abir K. Bekhet, Jaclene Zauszniewski

College of Nursing Faculty Research and Publications

More and more American older adults are relocating to retirement communities, and they experience challenges in adjusting to new surroundings that may increase their depression and mortality. An instrument not previously tested in the United States, the Index of Relocation Adjustment (IRA), may help in early identification of poor relocation adjustment. This study examined the psychometric properties of the IRA using secondary data from a convenience sample of 104 older adults who relocated to 6 retirement communities in Northeast Ohio. Cronbach’s alpha was .86. The IRA was correlated with measures of positive cognitions (r = .48, p < .01) and relocation controllability (r = …

Feasibility Of Oral Prenatal Probiotics Against Maternal Group B Streptococcus Vaginal And Rectal Colonization, Lisa Hanson, Leona Vandevusse, Megan Duster, Simone Warrack, Nasia Safdar

College of Nursing Faculty Research and Publications

Objective

To examine the effect of an oral prenatal probiotic on group B Streptococcus (GBS) colonization and to demonstrate the feasibility of a larger randomized controlled trial.

Design

This pilot study was an open‐label, two‐group quasi‐experiment.

Setting

An urban central city nurse‐midwifery and wellness center serving a diverse population.

Participants

Ten pregnant participants received the oral probiotic (Florajen3) taken once daily, and 10 participants served as controls.

Methods

A questionnaire on dietary practices, vaginal cleansing, sexual history, and symptoms and GBS colony count samples were taken at 28‐, 32‐, and 36‐weeks gestation.

Results

Participants in the probiotic group reported no …

Psychometric Properties Of The Resourcefulness Scale Among Caregivers Of Persons With Autism Spectrum Disorder, Abir K. Bekhet, Jaclene Zauszniewski

College of Nursing Faculty Research and Publications

Caregiving for children with autism spectrum disorder (ASD) can be very costly to caregivers’ well-being. Resourcefulness interventions have shown increases in positive health outcomes. However, before delivering the intervention, there should be a reliable and a valid measure to test resourcefulness. The psychometric properties of the Resourcefulness Scale (RS) have not been examined among ASD caregivers. This study examined the psychometrics of the 28-item RS in a convenience sample of 204 ASD caregivers. A Cronbach’s alpha of .91 showed the internal consistency of the RS. Construct validity was supported by the emergence of two dimensions of resourcefulness (personal and social) …

Palliative And End-Of-Life Care: Precepts And Ethics For The Orthopaedic Population, Cheryl L. Petersen, Susan Breakwell, Margaret Callahan

College of Nursing Faculty Research and Publications

Since the emergence of reports such as the National Consensus Project for Quality Palliative Care (2013) and the National Association of Orthopaedic Nurses Palliative Care Consensus Document (2005), there continues to be a growing recognition of the multiple adverse effects of serious illness and chronic conditions, as well as the potential benefits of receiving palliative or end-of-life care. As modern technology expands its ability to support life, ethical dilemmas may be encountered in the provision of palliative or end-of-life care. Through integration of the precepts of palliative care and consideration of the relevant ethical principles, orthopaedic nurses may best meet …

Phd Preparation For Nurse Faculty And Nurse Scientists: Do They Have To Be The Same?, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

No abstract provided.

Do You Use Your Professional Code Of Ethics?, Kathryn Schroeter

College of Nursing Faculty Research and Publications

No abstract provided.

Serum 25-Hydroxyvitamin D, Calcium, And Calcium-Regulating Hormones In Preeclamptics And Controls During First Day Postpartum, Ahmed Dalmar, Hershel Raff, Suneet P. Chauhan, Maharaj Singh, Danish S. Siddiqui

College of Nursing Faculty Research and Publications

The evidence for a link between vitamin D and preeclampsia is conflicting. There is a paucity of studies reporting simultaneous 25-hydroxyvitamin D (inactive form) and 1,25-dihydroxyvitamin D (biologically active form). We investigated if levels of serum 25-hydroxyvitamin D, calcium-regulating hormones (1,25-dihydroxyvitamin D, parathyroid hormone), and calcium differ significantly between preeclamptics and controls. On postpartum day one, 98 subjects (44 with preeclampsia, 54 controls) were recruited among women admitted to the postdelivery unit, and their serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, parathyroid hormone, serum calcium, and serum albumin levels were prospectively measured. The majority of participants (70 %) had serum 25-hydroxyvitamin D …

Use Of Ovulation Predictor Kits As Adjuncts When Using Fertility Awareness Methods (Fams): A Pilot Study, Rene Letva, Ula Burban, Edmond Kyrillos, Richard J. Fehring, Robin Mclaren, Catherine Dalzell, Elizabeth Tanguay

College of Nursing Faculty Research and Publications

Purpose: Difficult clinical signs such as confusing cervical mucus or erratic basal body temperature can make the use of fertility awareness methods (FAMs) difficult in some cases. The goal of this study was to assess the feasibility of using a cheap urinary luteinizing hormone (LH)–surge identification kit as an adjunct to identify the infertile phase after ovulation when facing these scenarios.

Methods: The study used a block-allocation, crossover, 2-arm methodology (LH kit/FAM vs FAM only). Comparison of the 2 arms was done with regard to the accuracy of identification (yes/no) of the luteal phase in each cycle as confirmed by …

Cohort Efficacy Study Of Natural Family Planning Among Perimenopause Age Women, Richard J. Fehring, Qiyan Mu

College of Nursing Faculty Research and Publications

Objective: To determine the efficacy of using natural family planning (NFP) methods to avoid unintended pregnancy among women of perimenopause age (i.e., age 40-55 years).

Design: A secondary analysis of subset data from two prospective observational cohort studies.

Setting: A university based in-person and online NFP service program.

Participants: One hundred and sixty couples who used either a website or an in-person NFP service to learn how to avoid pregnancy from January 2001 to November 2012.

Methods: A prospective 12-month effectiveness study among 160 women (between ages 40-55) who used NFP to avoid pregnancy. The …

Labor Down Or Bear Down: A Strategy To Translate Second-Stage Labor Evidence To Perinatal Practice, Kathryn Osborne, Lisa Hanson

College of Nursing Faculty Research and Publications

Scientific evidence supports spontaneous physiologic approaches to second-stage labor care; however, most women in US hospitals continue to receive direction from nurses and birth attendants to use prolonged Valsalva bearing-down efforts as soon as the cervix is completely dilated. Delaying maternal bearing-down efforts during second-stage labor until a woman feels an urge to push (laboring down) results in optimal use of maternal energy, has no detrimental maternal effects, and results in improved fetal oxygenation. Although most commonly used with women who are undergoing epidural anesthesia, laboring down is just one component of physiologic second-stage labor care that can be used …

Supporting Labor Progress Toward Physiologic Birth, Lisa Hanson, Leona Vandevusse

College of Nursing Faculty Research and Publications

No abstract provided.

Factors Associated With The Emotional Distress Of Women Family Members Of Adults With Serious Mental Illness, Jaclene Zauszniewski, Abir K. Bekhet

College of Nursing Faculty Research and Publications

Women family members of adults with serious mental illness are at great risk for emotional distress. This study examined associations between characteristics of 60 women (age, race, and education), their relatives with mental illness (age, diagnosis, and years since diagnosis), and the family situation (relationship, living arrangements, and care provided) and symptoms of emotional distress. Depressive symptoms were greater among those with younger, non-sibling relatives. Anxiety was greater among Caucasians and those with a recently diagnosed family member, particularly bipolar disorder. Anger was associated with providing direct care. The findings are informative for tailoring interventions to minimize emotional distress in …

Spirituality And Religiosity In Adolescents With Sickle Cell Disease: A Descriptive Qualitative Study, Dora L. Clayton-Jones

Dissertations (1934 -)

Sickle cell disease (SCD) is a serious debilitating chronic illness and global health problem. Spirituality and religiosity have been shown to have positive correlations with their health outcomes. Research addressing the spiritual and religious needs of adolescents living with SCD is limited.

The aim of this descriptive qualitative study was to examine how adolescents (Mage = 16.2 years) with SCD describe and experience spirituality and religiosity. Nine adolescents completed two semi-structured interviews. Sickle Cell Disease Interview Guides were developed using the Spiritual Development Framework developed by Benson & Roehlkepartain (2008) as a guide. The framework provided a foundation for conceptualizing …

Compassion Fatigue: An Unwanted Reflection Of Your Reality, Kathryn Schroeter

College of Nursing Faculty Research and Publications

No abstract provided.

Current Medical Research Winter–Spring 2013, Richard J. Fehring

College of Nursing Faculty Research and Publications

No abstract provided.

Individual Characteristics And Relocation Factors Affecting Adjustment Among Relocated American And Egyptian Older Adults, Abir K. Bekhet, Jaclene A. Zauszniewski

College of Nursing Faculty Research and Publications

Worldwide, the population of elders is increasing significantly. Relocation can be a positive or a negative experience, depending on many factors, including culture. The purpose of this study is to compare individual characteristics (age, gender, marital status, education, perceived health status, activities of daily living), relocation factors (movement preparation, time passed since relocation, closeness of prior home to the present, and whether relocation was from home or another facility), and adjustment in relocated American and Egyptian elders. This secondary analysis study merged data from two cross-sectional descriptive studies of a 104 elders relocated to retirement communities in Northeast Ohio and …

Validation Of Patient And Nurse Short Forms Of The Readiness For Hospital Discharge Scale And Their Relationship To Return To The Hospital, Marianne E. Weiss, Linda L. Costa, Kathleen Bobay, Olga Yakusheva

College of Nursing Faculty Research and Publications

Objective: To validate patient and nurse short forms for discharge readiness assessment and their associations with 30-day readmissions and emergency department (ED) visits.

Data Sources/Study Setting: A total of 254 adult medical-surgical patients and their discharging nurses from an Eastern US tertiary hospital between May and November, 2011. Study Design Prospective longitudinal design, multinomial logistic regression analysis.

Data Collection/Extraction Methods: Nurses and patients independently completed an eight-item Readiness for Hospital Discharge Scale on the day of discharge. Patient characteristics, readmissions, and ED visits were electronically abstracted.

Principal Findings: Nurse assessment of low discharge readiness was associated with a six- to …

A Feminist Perspective On Listening To Women: Birth Stories Of Vaginal Birth Following Previous Cesarean Delivery, Elizabeth Hill-Karbowski

Dissertations (1934 -)

Women's perspectives of their experiences are important, and worthy of study. However, there have been no qualitative comparative investigations of vaginal birth after cesarean (VBAC) experiences of American women using their birth stories as data. Furthermore, there have been no studies where women's experiences of cesarean have been compared with their own subsequent VBAC.

The purpose of this study was to gain insight into the comparative experience of VBAC and cesarean, valuing women and their experiences through the use of a feminist research perspective. By contributing new and valuable insight into an area of research that has been identified as …

Two-Method Planned Missing Designs For Longitudinal Research, Mauricio Garnier-Villarreal, Mijke Rhemtulla, Todd D. Little

College of Nursing Faculty Research and Publications

We examine longitudinal extensions of the two-method measurement design, which uses planned missingness to optimize cost-efficiency and validity of hard-to-measure constructs. These designs use a combination of two measures: a “gold standard” that is highly valid but expensive to administer, and an inexpensive (e.g., survey-based) measure that contains systematic measurement bias (e.g., response bias). Using simulated data on four measurement occasions, we compared the cost-efficiency and validity of longitudinal designs where the gold standard is measured at one or more measurement occasions. We manipulated the nature of the response bias over time (constant, increasing, fluctuating), the factorial structure of the …

The Impact Of Patient–Provider Communication And Language Spoken On Adequacy Of Depression Treatment For U.S. Women, Abiola O. Keller, Ronald Gangnon, Whitney P. Witt

College of Nursing Faculty Research and Publications

Many women with depression are untreated or undertreated for their condition. The quality of patient–provider communication may impact the receipt of depression treatment. We examine the relationship between patient–provider communication and receipt of adequate treatment for depression among women. The study sample consisted of women with depression who visited a provider in the previous 12 months in the 2002–2008 Medical Expenditure Panel Survey (N = 3,179). Multivariate regression was used to examine the independent contribution of sociodemographic characteristics, health care factors, patient–provider communication, and respondent language on depression treatment status (none, some, adequate). We found that more than one-third of …

Prueba Go/No-Go, Mauricio Garnier-Villarreal, Luis Diego Conejo Bolaños

College of Nursing Faculty Research and Publications

No abstract provided.

Family Caregivers’ Knowledge Of Delirium And Preferred Modalities For Receipt Of Information, Margaret J. Bull, Lesley Boaz, Jennifer M. Sjostedt

College of Nursing Faculty Research and Publications

Delirium is a life-threatening, frequently reversible condition that is often a sign of an underlying health problem. In-hospital mortality alone for older adults with delirium ranges from 25% to 33%. Early recognition of delirium is critical because prolonged duration poses a greater risk of poor functional outcomes for older adults. Family caregivers, who are familiar with the older adult’s usual behaviors, are most likely to recognize delirium symptoms but might dismiss them as due to aging. It is important to learn what family caregivers know about delirium to ascertain their need for education. The aims of this study were to …

Strategies For A Successful Phd Program: Words Of Wisdom From The Wjnr Editorial Board, Vicki S. Conn, Julie Zerwic, Susan M. Rawl, Jean F. Wyman, Janet L. Larson, Cindy M. Anderson, Nancy L. Fahrenwald, Lazelle E. Benefield, Marlene Z. Cohen, Carol E. Smith, Robert V. Topp, Natalie E. Markis

College of Nursing Faculty Research and Publications

Nursing doctoral programs prepare students for research-focused careers within academic settings. The purpose of this Editorial Board Special Article is to provide PhD students and advisors with suggestions for making the most of their doctoral experience. Editorial Board members provide their individual insights on the skills and attributes students must acquire during the course of their doctoral education in order to succeed. The authors provide practical tips and advice on how to excel in a PhD program, including how to select an advisor and a dissertation committee, the importance of attending conferences to increase visibility and develop a network of …

A Comparison Of Quality Of Care In Critical Access Hospitals And Other Rural Hospitals, Marianne Baernholdt, Jessica Keim-Malpass, Ivora D. Hinton, Guofen Yan, Marilyn Meyer Bratt

College of Nursing Faculty Research and Publications

Purpose:

The United States has about 2100 rural hospitals. Approximately 1300 are Critical Access Hospitals (CAHs) with 25 beds or less. CAHs receive cost-based reimbursement through the federal Flex program with the goal to improve quality and access to health care. Reports on quality of care (QOC) and factors that influence quality in CAHs are mixed. This study compared QOC and factors that influence QOC in CAHs and other rural hospitals.

Sample: 385 staff nurses in 6 CAHs and 9 other rural hospitals in North Carolina and Virginia.

Method:

Descriptive cross-sectional design using nurse surveys aggregated to the hospital level, …

Psychometric Evaluation Of An Instrument To Measure Hispanic Mothers’ Normative Beliefs, Intentions, Past Experience And Past Behavior Related To The Discussion Of Sex-Related Topics With Their Adolescent Daughters, Dana Rodriguez, Robert V. Topp, Richard J. Fehring

College of Nursing Faculty Research and Publications

Aim: The aim of this project was to describe the psychometric properties of a recently developed instrument that measures Hispanic mother normative beliefs, intentions, past experience, and past behavior regarding the Discussion of Sex-Related Topics (DSRTs) with their adolescent daughters.

Background: The DSRTs between Hispanic mothers and their adolescent daughters is important because this interaction has been found to be a protective factor against the daughter’s risk for STDs and unintended pregnancy. Hispanic mother talk less with their daughters about sex-related topics (SRTs) than other ethnic groups. The Rodriguez Normative Belief Instrument (RNBI) has been established to measure …