Nursing Commons^™

The Present State Of Nfp Science, The Challenges We Face, Richard J. Fehring

College of Nursing Faculty Research and Publications

No abstract provided.

Psychometric Evaluation Of The Shared Care Instrument In A Sample Of Home Health Care Family Dyads, Margaret Sebern

College of Nursing Faculty Research and Publications

Researchers have studied negative effects of caregiving on a family caregiver; however, less is known about positive aspects of exchanging assistance for both members of a family caregiving dyad. In a previous naturalistic inquiry the author indentified a basis for studying caregiving interactions was a construct called shared care. The three components of shared care identified in the naturalistic inquiry were communication, decision making, and reciprocity. The Shared Care Instrument (SCI) was developed to measure the construct. The purpose of this study was to assess the psychometric properties of the SCI, and to assess its construct and criterion-related validity. A …

A Systematic Review Of Mammography Educational Interventions For Low-Income Women, Tatiana Bailey, Jorge Delva, Kimberlee A. Gretebeck, Kristine Siefert, Amid I. Ismail

College of Nursing Faculty Research and Publications

Objective

We conducted a systematic review to examine the effectiveness of educational interventions in increasing mammography screening among low-income women.

Data Sources

Bibliographic databases, including MEDLINE, The Cochrane Central Register of Controlled Trials, The Cochrane Database of Systematic Reviews, and the ISI Web of Science, were searched for relevant articles.

Study Inclusion and Exclusion Criteria

Randomized, community-based trials targeting low-income women and published between January 1980 and March 2003 were included.

Data Extraction

The search yielded 242 studies; 24 met all inclusion criteria.

Data Synthesis

Three studies used mammography vans, three used low-cost vouchers or provided free mammograms, three used …

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

College of Nursing Faculty Research and Publications

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 …

Cigarette Smoking Among Low-Income African Americans: A Serious Public Health Problem, Jorge Delva, Marisol Tellez, Tracy L. Finlayson, Kimberlee A. Gretebeck, Kristine Siefert, David R. Williams, Amid I. Ismail

College of Nursing Faculty Research and Publications

Background

This study examines the current prevalence of cigarette smoking and the number of cigarettes smoked in a community-based sample of 1021 low-income African-American men and women.

Methods

Participants were selected using a two-stage, area probability sample design. Data were collected in 2002–2003 in face-to-face interviews and analyzed in 2005. All data and analyses were weighted to account for the complex sampling design.

Results

Fifty-nine percent of men and 41% of women were current smokers, with younger individuals apparently initiating smoking at an earlier age than older individuals.

Conclusions

The high prevalence of cigarette use provides further evidence that the …

Basal Body Temperature Assessment: Is It Useful To Couples Seeking Pregnancy?, Mary Lee Barron, Richard J. Fehring

College of Nursing Faculty Research and Publications

Advanced practice nurses in primary care settings are often asked to give appropriate advice to couples seeking pregnancy. This article examines the issue of basal body temperature (BBT), a time-honored way to establish the presence of ovulatory cycles, and asks if BBT is an outdated recommendation. The article also reviews the benefits and limitations of recommending BBT to couples seeking pregnancy in light of recent fecundity research.

Protocol For Determining Fertility While Breastfeeding And Not In Cycles, Richard J. Fehring, Mary Lee Barron, Mary Schneider

College of Nursing Faculty Research and Publications

A protocol was developed and evaluated for nonovulating breastfeeding women to determine potential fertility with an electronic hormonal fertility monitor. The amount of required abstinence (i.e., days of potential fertility) through the first menstrual cycle indicated by the fertility monitor was significantly lower (17% of the total days) compared with the amount of abstinence (50% of the total days) indicated by the self-observation of cervical mucus.

Patient Safety. From Metaphor To Model: The Clarian Safe Passage Program, Kathryn Rapala, Karlene M. Kerfoot

College of Nursing Faculty Research and Publications

The most important stakeholders in patient safety are alert and mobilized frontline health care staff. At Clarian Health Partners, Indianapolis, IN, clinicians in the Safe Passage Program work jointly with unit staff, physicians, and other departments to continuously improve the level of patient, employee, and visitor safety. Medical error reporting at Clarian has tripled. The enthusiasm and passion of Safe Passage clinicians is both inspiring and energizing.

Aiming For Zero Errors: Clarian’S Safe Passage Program Improves Infusion Safety, Dawn Daniels, Kathryn Rapala

College of Nursing Faculty Research and Publications

Few issues command as much attention in the healthcare industry as patient safety. As healthcare professionals and hospital administrators know, nurses are key players in patient safety programs. Nurses are at the best vantage point to see, report, and fix errors before they occur, and the high-touch nature of their jobs puts nurses in the best seat to advocate for a patient and address looming safety issues.

Hospitals across the country are recognizing nurses’ critical role in patient safety, and as a result, more nurses are being placed in pivotal care roles. Clarian Health Partners, a hospital system based in …

Adaptation To Cesarean Birth: Implementation Of An International Multisite Study, Jacqueline Fawcett, Cynthia Aber, Marianne E. Weiss, Susan Haussler, Sheila Taylor Myers, Charlette King, Jennifer Newton, Virginia Silva

College of Nursing Faculty Research and Publications

The purpose of this column is to describe the implementation of an international multisite Roy adaptation model-based study of women’s perceptions of and responses to cesarean birth. The need for the study arose from the concern that women’s childbearing needs may not be met to their full satisfaction, especially if the infant is born by cesarean. Serendipity and networking played a part in the selection of four study sites in the United States (Boston, Milwaukee, Norfolk, Oklahoma City) and two in other countries (Finland, Australia). Data were collected by nursing students and staff nurses. Post-hoc consideration of the diversity of …

Mentoring Staff Members As Patient Safety Leaders: The Clarian Safe Passage Program, Kathryn Rapala

College of Nursing Faculty Research and Publications

We are at a crossroad in patient safety. Patient safety definitions, research, products, and implementation strategies have become as complex as health care itself. Almost every professional and regulatory organization now has a position or strategy to address the estimated 44,000 to 98,000 deaths per year due to health care error[1]. Memorizing and implementing the Joint Commission for Accreditation National Patient Safety Goals is not enough to establish and maintain a culture of safety. Patient safety literature offers few practical solutions on the implementation of an integrated, system wide application of patient safety approaches to clinical practice. It is our …

Promoting Healthful Diets And Exercise: Efficacy Of A 12-Week After-School Program In Urban African Americans, Hermann-J. Engels, Randall J. Gretebeck, Kimberlee A. Gretebeck, Linda Jimenez

College of Nursing Faculty Research and Publications

This study examined the effectiveness of a unique extracurricular after-school initiative designed to promote healthy diets and exercise in urban African Americans. The Students and Parents Actively Involved in Being Fit after-school program was offered for 12 weeks to students and their parents/guardians at an urban middle school. Specific aims of the intervention were to increase participants’ vegetable and fruit intake by using established 5 A Day for Better Health educational resource materials/activities and to affect their health-related fitness through dance, games, and fitness activities. Fifty-six children and 25 parents/guardians completed a standard battery of evaluations before and after the …

Determinants Of Physical Activity And Low-Fat Diet Among Low Income African American And Hispanic Middle School Students, Marilyn Frenn, Shelly Malin, Antonia M. Villarruel, Kimberly Slaikeu, Stephanie Mccarthy, Joan Freeman, Erinn Nee

College of Nursing Faculty Research and Publications

African Americans, Hispanics, and those with low income experience disproportionate health problems that can be prevented by physical activity and a lower fat diet. In this descriptive cross-sectional study, antecedents of diet and exercise within the Health Promotion/Transtheoretical Model were examined among low-income African American and Hispanic seventh-grade students (n = 127). Total support was associated with higher physical activity for girls. African Americans perceived greater social support for activity than Hispanics. Family models and support for physical activity and low-fat diet were greater as family income increased. However, higher family role models and lower dietary fat were found …

Changing The Tide: An Internet/Video Exercise And Low Fat Diet Intervention With Middle School Students, Marilyn Frenn, Shelly Malin, Roger L. Brown, Yvonne Greer, Jaime Fox, Jennifer Greer, Sarah Smyczek

College of Nursing Faculty Research and Publications

The rising tide of obesity erodes the health of youths and many times results in adult obesity. The purpose of this investigation was to examine the effectiveness of an eight-session health promotion/transtheoretical model Internet/video-delivered intervention to increase physical activity and reduce dietary fat among low-income, culturally diverse, seventh-grade students. Those who completed more than half the sessions increased exercise, t(103) = −1.99, p = .05, and decreased the percentage of dietary fat, t(87) = 2.73, p = .008. Responses to the intervention by stage of change, race, and income are examined.

Medical Students' Knowledge Of Midwifery Practice After Didactic And Clinical Exposure, Lisa Hanson, Jackie Tillett, Russell S. Kirby

College of Nursing Faculty Research and Publications

Information concerning the student outcomes of interdisciplinary education is limited. The purpose of this study was to identify the knowledge of third‐year medical students regarding the practice of certified nurse‐midwives (CNMs). A 1‐page survey instrument was developed and pretested. The instrument was administered as a pre‐ and posttest at the beginning and end of 7 Obstetrics and Gynecology rotations at 2 medical school clinical campuses of a large Midwestern medical school. Direct interaction with CNMs improved knowledge of collaborative practice arrangements and roles. This was particularly evident in knowledge areas related to CNM prescriptive authority. The medical students who had …

New Low- And High-Tech Calendar Methods Of Family Planning, Richard J. Fehring

College of Nursing Faculty Research and Publications

Calendar-based methods are not usually considered effective or useful methods of family planning among health professionals. However, new “high-” and “low”-tech calendar methods have been developed, which are easy to teach, to use, and may be useful in helping couples avoid pregnancy. The low-tech models are based on a fixed-day calendar system. The high-tech models are based on monitoring urinary metabolites of female reproductive hormones. Both systems have high levels of satisfaction. This article describes these new models of family planning and the research on their effectiveness. The author proposes a new algorithm for determining the fertile phase of the …

Attitudes, Intentions, And Ethical Stance Of Advanced Practice Nursing Students Toward Abortion Provision: Part One B Quantitative Findings, Richard J. Fehring

College of Nursing Faculty Research and Publications

The availability of pre-implantation abortion pills has increased the probability that advanced practice nurses (i.e., nurse practitioners and certified nurse midwives) will be instrumental in providing abortion services in the United States. The purpose of this pilot study was to determine the attitudes, intentions, and ethical stance of advanced practice nursing students towards the provision of abortion services. The study was a descriptive cross-sectional survey of 53 advanced practice nursing students at a private Midwestern Catholic university. A multi-item abortion attitude survey was administered to students in three required courses. The survey included a section on ethical principles and open-ended …

Conducting Life History Research With Adolescents, Kristin Haglund

College of Nursing Faculty Research and Publications

This article is a commentary on the life history approach, which specifically described aspects of and offered suggestions for conducting life history research with adolescents. The life history approach is well suited to a wide variety of types of health-related inquiry. In this article, the author used an exemplar study to show how well the life history approach was suited for questions regarding adolescent issues. This approach was also a good match for the developmental skills and needs of adolescents. The author uses the strengths and weaknesses of the approach and a detailed example of how she used the life …

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

College of Nursing Faculty Research and Publications

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. …

Length Of Stay After Vaginal Birth: Sociodemographic And Readiness-For-Discharge Factors, Marianne E. Weiss, Polly Ryan, Lisa Lokken, Magdalen Nelson

College of Nursing Faculty Research and Publications

Background: The impact of reductions in postpartum length of stay have been widely reported, but factors influencing length of hospital stay after vaginal birth have received less attention. The study purpose was to compare the sociodemographic characteristics and readiness for discharge of new mothers and their newborns at 3 discharge time intervals, and to determine which variables were associated with postpartum length of stay.

Methods: The study sample comprised 1,192 mothers who were discharged within 2 postpartum days after uncomplicated vaginal birth at a tertiary perinatal center in the midwestern United States. The sample was divided into 3 postpartum length-of-stay …

Couples' Views Of The Effects Of Natural Family Planning On Marital Dynamics, Leona Vandevusse, Lisa Hanson, Richard J. Fehring, Amy Newman, Jaime Fox

College of Nursing Faculty Research and Publications

Purpose: Natural Family Planning (NFP) requires periodic abstinence and partner cooperation to prevent pregnancy. The aim of this study was to learn about the effects of modern NFP methods on marital relationships. Design: Descriptive survey. Methods: Questionnaires were mailed to 1,400 randomly selected couples known to use NFP and residing in the United States of America; 334 couples (24%) responded. Content analysis was used to identify meanings and themes. Numeric analyses were used to determine frequencies. Findings: Nearly two-thirds of the qualitative comments were positive. Four themes were identified in the positive responses: relationship enhancements, knowledge improvements, spirituality enrichments, and …

Change In Diet, Physical Activity, And Body Weight In Female College Freshman, Scott M. Butler, David R. Black, Carolyn L. Blue, Randall J. Gretebeck

College of Nursing Faculty Research and Publications

Objective: To examine diet, physical activity, and body-weight changes associated with relocation from home to university.

Methods: Diet, fitness/physical activity, body-weight parameters and self-efficacy were assessed among 54 freshman women upon college entry and 5 months later.

Results: Although caloric intake significantly decreased, a significant increase occurred in body-weight parameters that may be attributed to significant decreases in total physical activity.

Conclusions: Interventions are needed aimed at increasing physical activity; improving diet quality related to consumption of vegetables, fruits, breads and pasta, and meats; and decreasing alcohol consumption.

The Future Of Professional Education In Natural Family Planning, Richard J. Fehring

College of Nursing Faculty Research and Publications

Nurses and other health care professionals often have little knowledge of methods of natural family planning (NFP) and do not readily prescribe natural methods for their patients. One reason for this is that little or no information on NFP is provided in nursing or medical schools. The holistic, informational, and integrative nature of NFP fits well with professional nursing practice. A university online distance education NFP teacher training program, which offers academic credit and includes theory, practice, and the latest developments in fertility monitoring, has been developed for health care professionals. Professional NFP services in the United States need to …

A Comparison Of The Fertile Phase As Determined By The Clearplan Easy Fertility Monitor™ And Self-Assessment Of Cervical Mucus, Richard J. Fehring, Kathleen Raviele, Mary Schneider

College of Nursing Faculty Research and Publications

The purpose of this study was to compare the fertile phase of the menstrual cycle as determined by the Clearplan Easy Fertility Monitor (CPEFM) with self-monitoring of cervical mucus. One-hundred women (mean age = 29.4 years) observed their cervical mucus and monitored their urine for estrogen and luteinizing hormone metabolites with the CPEFM on a daily basis for 2–6 cycles and generated 378 cycles of data; of these, 347 (92%) had a CPEFM peak. The beginning of the fertile window was, on average, day 11.8 (SD = 3.4) by the monitor and day 9.9 (SD = 3.0) by cervical mucus …

Southeast Asian Refugee Children: Self-Esteem As A Predictor Of Depression And Scholastic Achievement In The U.S., Patricia G. Fox, Kenneth R. Burns, Judith M. Popovich, Ruth Ann Belknap, Marilyn Frank-Stromborg

College of Nursing Faculty Research and Publications

The eruption of conflicts and war in this century has led to new masses of refugees and displaced persons. Globally, host countries will continue to confront issues of how to ensure the successful adaptation of refugees who typically are women and children. The United States received three major waves of Southeast Asian (SEA) refugees during the past twenty-five years. One million SEA refugees arrived in the past decade; the majority were children and adolescents. Today, there is still a lack of understanding surrounding mental health issues and their relationship to children's violence experience. We know that SEA refugee children suffered …

The Wisconsin Fetal Alcohol Syndrome Screening Project, Marianne E. Weiss, Christine E. Cronk, Sandra Mahkorn, Randall Glysch, Sara Zirbel

College of Nursing Faculty Research and Publications

Problem: Fetal Alcohol Syndrome (FAS) is preventable, under-diagnosed, and under-reported. Wisconsin rates for alcohol use and binge drinking in childbearing-age women exceed the national average. FAS prevalence in Wisconsin has not previously been systematically evaluated. Methods: The Wisconsin Fetal Alcohol Syndrome Screening Project (WFASSP) used a multi-stage, multi-source prospective population-based screening methodology to identify children born in 1998-1999 in Southeast Wisconsin who met a surveillance case definition for FAS. The 4-stage methodology used screening of electronic birth files, abstraction of neonatal medical records, and direct assessment of facial features, growth, and development at age 2 to 3 years. Results: The …

The Perceived Value Of Certification By Certified Perioperative Nurses, Kathleen B. Gaberson, Kathryn Schroeter, Aileen R. Killen, Wendelny A. Valentine

College of Nursing Faculty Research and Publications

We conducted this study to determine the perceived value of certification in perioperative nursing. Following development and pilot-testing, we mailed the 18-item Likert-type instrument, the Perceived Value of Certification Tool (PVCT), to a sample of 2750 perioperative nurses who had earned the CNOR or CRNFA credential or both. A total of 1398 surveys were returned (50.8% response rate). Factor analysis extracted three factors, accounting for 61% of the variance: personal value, recognition by others, and professional practice. Internal consistency reliability testing (Cronbach's α) identified a standardized α of .924. Over 90% of respondents agreed or strongly agreed with statements about …

Beneficial Effects Of Flexible Insulin Therapy In Children And Adolescents With Type 1 Diabetes Mellitus, Ramin Alemzadeh, P. Palma-Sisto, Elaine Parton, Joan P. Totka, Mary De Sales Kirby

College of Nursing Faculty Research and Publications

The purpose of this study was to determine the feasibility of a flexible multiple daily insulin (FMDI) regimen in routine pediatric diabetes care by comparing HbA_1c, body mass index (BMI), and episodes of severe hypoglycemia (SH) before and after initiation of FMDI therapy. Data from 44 patients (2-16 years old), on a conventional insulin (CI) regimen, were collected during quarterly diabetes clinic visits. These patients were transitioned from CI to FMDI regimen: pre-meal lispro (bolus) and once or twice daily Humulin Ultralente with or without bedtime Humulin NPH as the basal insulin. There was a significant improvement in …

Diet And Exercise In Low Income, Culturally Diverse Middle School Students, Marilyn Frenn, Shelly Malin

College of Nursing Faculty Research and Publications

It is important to understand constructs essential to low-fat-diet and physical-activity behaviors of low-income culturally diverse middle-school-age students, because ethnicity and socioeconomic status influence body weight status, and these groups are most at risk for obesity later in life. In this descriptive study, constructs important in low-fat diet and physical activity in low- to middle-income, culturally diverse middle school students were examined. Revised for cultural/developmental appropriateness and reading level, instruments incorporating constructs from the Health Promotion and Transtheoretical Models were tested with 221 youth. Results demonstrated that percentage of fat in diet, total number of strategies used for a low-fat …

Rh Negative Status And Isoimmunization Update: A Case-Based Approach To Care, Kathryn Shisler Harrod, Lisa Hanson, Leona Vandevusse, Patricia Heywood

College of Nursing Faculty Research and Publications

Prior to the 1970s and the advent of Rho (D) immune globulin (RIG) for Rh negative women, hemolytic disease of the newborn led to morbidity, long-term disabilities, and mortality. Antepartum RIG administration has been a standard of practice since 1983. Yet, Rh isoimmunization (sensitization) and its sequelae have not been completely eradicated. Rh-related issues remain clinical challenges facing perinatal and neonatal nurses. Evidence for the administration of RIG prenatally and during the postpartum period is presented including controversies and challenges. Current information about fetal and neonatal care of erythroblastosis fetalis and immune hydrops is also presented.