Applied Nursing Research - Articles in Press

Participation of elder persons, families, and health care teams in hospital discharge destination decisions - Corrected Proof

Lori Popejoy — 2010-01-15

Abstract: This study identified that hospitalized elder persons and their family preferred active or collaborative level of participation (LOP) in discharge destination decisions, whereas health care team members (HCTMs) preferred passive LOP. Recognition of preferred LOP by HCTMs is instrumental to developing discharge plans that are tailored to the individual's need and are realistic and achievable.

The Barthel Index: comparing inter-rater reliability between Nurses and Doctors in an older adult rehabilitation unit - Corrected Proof

Irene Hartigan, Denis O'Mahony — 2010-01-15

Abstract: Objective: To ensure accuracy in recording the Barthel Index (BI) in older people, it is essential to determine who is best placed to administer the index. The aim of this study was to compare doctors' and nurses' reliability in scoring the BI.Methods: Sixty-five consecutive patients admitted to an older adult rehabilitation unit were assessed using the BI. Four raters recorded the BI on all patients. BI scores were compared for equivalence on the level of agreement between raters.Results: Near-perfect correlation in the total scores between raters indicated that the final score is reliable. There was a statistically significant bias by doctors who gave a higher BI score than nurses with a mean difference of 1.2 (95% confidence interval). Nurses demonstrated good and very good agreement on all 10 items, whereas doctors demonstrated good agreement on only 5 items.Conclusion: The BI is highly reliable when recorded by nurses with low interrater variation, whereas between doctors, there is greater variation. When assessing older adult's activities of daily living, there is greater interrater reliability in the BI score when the patient is observed performing the activities of daily living compared to the self-report method.

The effect of a double-regression hospital bed on interface pressure - Corrected Proof

Ricardo Ros-Mar, Marino Martínez-Gamarra — 2010-01-15

Abstract: This study examines, for the first time, the differences of interface pressure in different positions on a standard hospital bed and a double-regression hospital bed. For both beds, the interface pressure was recorded in four supine positions and three lateral positions in 49 healthy volunteers (30 men and 19 women). The results demonstrate, independently of the bed type, that when a supine and lateral position is indicated, the 0° and 30° positions, respectively, are preferable. We also show that patients requiring prolonged upper body elevation may benefit from the use of a double-regression hospital bed that reduces the maximum pressure and the pressure surface greater than 32 mm Hg at the sacrum and heel sites.

Using PDAs to detect cognitive change in the hospitalized elderly patient - Corrected Proof

Margarete L. Zalon, Sonia Sandhaus, Donna Valenti, Ulyana Arzamasova — 2009-11-30

Abstract: The Hospital Elder Life Program (HELP) program is designed to prevent delirium and cognitive decline in the hospitalized elderly patient. Personal digital assistants (PDAs) were trialed in collecting assessment data for the HELP program. Data for a mental status assessment (Mini-Mental Status Examination), delirium assessment (Confusion Assessment Method), and a depression screen for 352 patients enrolled over a 4-month period were collected. Participants had a slight but significant increase in cognitive function. PDAs are a useful adjunct to care enabling the staff to monitor the cognitive status of hospitalized elderly patients and track program outcomes.

Relationship between job stress level and coping strategies used by Hong Kong nurses working in an acute surgical unit - Corrected Proof

Wenru Wang, Amelia Wai Man Kong, Sek Ying Chair — 2009-10-26

Abstract: Objective: The aim of this study is to explore the relationship between job stress and coping strategies of Hong Kong nurses working in an acute surgical unit.Method: This is a descriptive correlational study. Data were collected from 98 Hong Kong surgical nurses using the Nursing Stress Scale and the Jalowiec Coping Scale.Results: Results showed that workload (M = 15.36), lack of support (M = 13.32), and inadequate preparation (M = 12.33) are the most common stressors for Hong Kong surgical nurses. The most frequent strategies used by nurses to cope with stress can be characterized as evasive (M = 19.23), confrontive (M = 17.46), and optimistic (M = 15.81), all of which are also rated as the most effective strategies in reducing stress levels. Only the confrontive, optimistic, supportant, and emotive coping strategies reveal significant correlations (p < .05) with the stress levels of nurses, whereas the evasive, fatalistic, palliative, and self-reliant strategies showed no significant correlation with stress levels (p > .05).Conclusion: Recognizing the impacts of job-related stress and making use of effective coping methods play a vital role in reducing nurse's stress. A change in leadership styles from the managerial level and reallocation of manpower may help reduce job stress. The use of confrontive and optimistic coping strategies in reducing job-related stress for surgical nurses should be advocated and promoted in their daily work.

Online research in older adults: lessons learned from conducting an online randomized controlled trial - Corrected Proof

2009-10-26

Abstract: The Internet has revolutionized health care delivery. With the increasing number of online users and the advancement of eHealth technologies, many health care studies have been conducted online. However, online research is still a relatively new field, and many methodological issues still need to be investigated. Over the years, the authors have conducted studies on various aspects of online health intervention research, including development and usability testing of online health interventions, Web surveys, and an online randomized controlled trial employing older adult online users. The purpose of this article was to describe lessons learned from conducting an online randomized controlled trial designed to improve older adults' health behaviors focusing on methodological issues and strategies to overcome them.

Rural Black women's thoughts about exercise - Corrected Proof

Laura K. Evans — 2009-10-26

Abstract: This ethnographic study explored 20 southern rural Black women's thoughts about and practices of exercise. Qualitative analysis revealed four factors: (a) exercise and the heart, (b) barriers to exercise, (c) reasons to exercise, and (d) taking action. Findings may assist clinicians and researchers to develop prevention interventions for this population.

Risk factors associated with unplanned endotracheal self-extubation of hospitalized intubated patients: a 3-year retrospective case-control study - Corrected Proof

Li-Chun Chang, Pei-Fen Liu, Yu-Lu Huang, Sien-Sing Yang, Wen-Yin Chang — 2009-10-22

Abstract: This 3-year retrospective case-control study aimed to identify risk factors associated with unplanned endotracheal self-extubation (UESE) of hospitalized intubated patients and to compare unplanned and planned extubation groups' characteristics of patients and nurses, vital signs, serum laboratory values, Glasgow Coma Scale scores, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, and use of physical restraints and sedatives. The study found that most UESEs occurred during evening or night shifts or during shifts staffed by nurses with less experience and less education. Most of the self-extubated patients (80%) were physically restrained. Pulse rate and APACHE II score were both significant predictors of UESE. Efforts to prevent UESEs should include identification of patients at higher risk.

Psychometric testing of the Inner Strength Questionnaire: women living with chronic health conditions - Corrected Proof

Kristi L. Lewis, Gayle Roux — 2009-10-16

Abstract: The purpose of this article is to report the third phase of psychometric testing on the Inner Strength Questionnaire. The instrument is a comprehensive gender-specific measure of inner strength in women living with chronic health conditions. The study sample was composed of 281 women with self-reported chronic health conditions. The four-factor structure was supported with a total of 27 items with loadings 0.50 or greater. The reliability for the entire instrument (Version 4) was .91. The instrument takes approximately 10–12 minutes to complete and is at the Flesch-Kincaide reading level of fourth grade. Results can be used to plan or test interventions used to enhance strength-building health outcomes in women.

Elective Cesarean births: are women making emancipated decisions? - Corrected Proof

Ruth A. Wittmann-Price, Rosemary Fliszar, Anand Bhattacharya — 2009-10-16

Abstract: This mixed method study investigated the extent to which women used emancipated decision making when selecting a birth method, whether they perceived they had a choice, and if they were satisfied with their decision. Findings suggest that vaginal birth is still the preferred method of delivery for these study participants.

A self-directed adherence management program for patients' with heart failure completing combined aerobic and resistance exercise training - Corrected Proof

Kathleen Duncan, Bunny Pozehl, Joseph F. Norman, Melody Hertzog — 2009-10-16

Abstract: This study measured the impact of the Exercise Adherence Management Program (EAMP) provided to 20 patients with heart failure (HF) who participated in a combined resistance and aerobic exercise training program during two 12-week phases. The EAMP included strategies designed to support exercise self-efficacy and adherence. Results indicate that an improvement in exercise self-efficacy occurred during the study period, whereas exercise adherence declined during the unsupervised phase. The highest rated adherence strategy for helpfulness and self-efficacy was group sessions. The study supports the use of adherence strategies based on self-efficacy in exercise programs for patients with HF.

Nursing Student Research Assistant Program: A strategy to enhance nursing research capacity building in a Magnet status pediatric hospital - Corrected Proof

Patricia A. Jamerson, Anne F. Fish, Geralyn Frandsen — 2009-10-16

Abstract: For busy clinicians, time to conduct research is scarce. A novel solution, the Nursing Student Research Assistant Program (NS-RAP), was designed in collaboration with area nursing schools to build research capacity at a pediatric hospital. Undergraduate and graduate nursing students participated in a variety of research experiences that, in turn, aided the conduct of clinician-initiated research at the pediatric hospital. In this article, conceptualization, implementation, outcomes, challenges, and future directions of NS-RAP are discussed.

Nurses' perception of how physical environment affects medication errors in acute care settings - Corrected Proof

Atiya Mahmood, Habib Chaudhury, Maria Valente — 2009-10-16

Abstract: The work that nurses perform in hospital environments is physically and psychologically intense, with the potential for burnout and stress. This issue is compounded by crowded and poorly designed work spaces in nursing units that can contribute to medical mistakes, including medication errors. This article is based on a study that examined the nurses' perception of how the physical environment in hospitals affects medication errors. Literature suggests that reduction of staff stress can be achieved through physical environmental considerations, such as improved air quality, acoustics, and lighting. However, there is no empirical study specifically exploring the relationship between aspects of the physical environment and medication errors. In this study, a cross-sectional survey was conducted with nursing staff (N = 84) in four hospitals in the Pacific Northwest region of the United States. The survey included questions on nursing unit design, medication room configurations, perceived incidence of errors, and adverse events. Respondents noted several physical environmental factors that are potentially problematic in the nursing station area and can lead to medication, documentation, and other types of nursing errors. These factors include inadequate space in charting and documentation area, lengthy walking distances to patient rooms, insufficient patient surveillance opportunity/lack of visibility to all parts of the nursing unit, small size of the medication room, inappropriate organization of medical supplies, high noise levels in nursing unit, poor lighting, and lack of privacy in the nursing stations. As administrators in acute care facilities consider strategies for organizational and staff interventions to reduce medication errors, it is important to consider physical environmental factors to have a comprehensive understanding of the issue.

Raising stroke awareness among rural dwellers with a Facts for Action to Stroke Treatment-based educational program - Corrected Proof

2009-09-22

Abstract: Stroke is the third leading cause of death in the United States with 780,000 new and/or recurrent strokes each year. Interventions aimed at the onset of stroke symptoms have been successful in decreasing long-term neurological deficits; however, providing the prompt medical interventions in rural areas involves unique challenges. To decrease time-to-treatment in rural areas, education about symptoms of stroke and the need for immediate medical attention are critical. The objective of this study was to measure the effectiveness of the Facts for Action to Stroke Treatment (FAST)-based educational intervention program focused on the improving knowledge about stroke of 402 rural-dwelling adults. Using a paired means t test, the participants had a significant increase in knowledge from pretest to posttest (p = .000). Of those, 215 subjects participated in 2-month follow-up testing with the paired t test showing that the increased score from pretest to 2-month follow-up remained significant (p = .000). The authors concluded that the FAST-based program was an effective tool to use when teaching recognition of stroke symptoms and the need for immediate medical intervention to rural adults.

Satisfaction and use of a spiritually based mantram intervention for childbirth-related fears in couples - Corrected Proof

2009-09-22

Abstract: This study assessed patient satisfaction with the use of a spiritually based (mantram/sacred word) intervention in expecting couples. A mixed-methods design, experimental repeated measures with interviews at 6-month follow-up was conducted. Satisfaction was moderate to high. Mantram was used for labor pains and uncertainty. Implications include scheduling flexible classes earlier in pregnancy. A larger randomized study is needed to assess intervention effectiveness.

Personality traits and chronic illness: a comparison of individuals with psychiatric, coronary heart disease, and HIV/AIDS diagnoses - Corrected Proof

2009-09-22

Abstract: This secondary analysis used the five-factor model of personality to examine personality traits in four samples of patients with chronic disorders. Profiles of personality traits differed across disorders. Although participants with psychiatric disorders and participants with HIV/AIDS had similar patterns of personality traits, patients with psychiatric disorders were more extreme on all traits except agreeableness. Patients with hyperlipidemia and those who had cardiothoracic transplants had similar patterns. Nurses and researchers need to consider personality traits that drive patterns of behavior in designing more effective ways to promote better health and manage disease.

Perceptions and experiences after radical prostatectomy in Turkish men: a descriptive qualitative study - Corrected Proof

Emine Iyigun, Hatice Ayhan, Sevinc Tastan — 2009-09-22

Abstract: Radical prostatectomy (RP) can significantly influence men's quality of life. Data from the Ministry of Health's Fight With Cancer Office Directorate in 2003 show that prostate cancer is third among the 10 most common types of cancer in men, with an incidence of 5.97% in the population. The objectives of this study were to define the experiences and perceptions of Turkish men who have undergone RP and to determine the views and suggestions of men who had undergone RP as to their discharge training content. Following the RP, urinary incontinence (UI) and erectile dysfunction (ED) negatively affect the daily life of men. It has been determined that men need support to deal with these problems they met. Being discharged without obtaining information from the health care staff regarding home catheter care and UI and ED management causes men to experience difficulties and find it difficult to cope when faced with these problems.

Validation and testing of the Acceptability E-scale for Web-based patient-reported outcomes in cancer care - Corrected Proof

Joseph D. Tariman, Donna L. Berry, Barbara Halpenny, Seth Wolpin, Karen Schepp — 2009-09-22

Abstract: The performance of the Acceptability E-scale was tested in a sample of 627 adult and older adult patients from various oncology clinics who completed an electronic symptoms survey. The revised Acceptability E-scale has strong psychometric properties and can be useful in assessing the acceptability and usability of computerized health-related programs in oncology and other health population.

Health care professionals' attitudes about obesity: An integrative review - Corrected Proof

Geraldine M. Budd, Megan Mariotti, Diane Graff, Kathleen Falkenstein — 2009-09-22

Abstract: Stigma and discrimination against obese people are common and related to individual attitudes about obesity. Despite a robust field of study on attitudes related to obesity, no integrative review of health providers' beliefs exist. Fifteen studies (1990–2007) on various health care providers are examined along with practice implications. Analysis indicates that attitudes toward overweight patients, although primarily still negative, have improved over time. Findings indicate that care dispensed to obese patients is not as likely to be affected by health care providers' attitudes as in the past. Implications include the need for additional research, awareness education, and practice guidelines.

A theory-based problem-solving approach to recruitment challenges in a large randomized field trial - Corrected Proof

2009-09-22

Abstract: Despite best-laid plans, recruitment problems arise in large field trials. Research teams must work hard on problem solving and push comfort zones to sustain recruitment and accrual levels. A systematic theory-based problem-solving approach helped us look deeply for challenges and implement strategies continuously to sustain accrual to our target enrollment.

Triangulating the extrinsic risk factors for inpatient falls from the fall incident reports and nurse's and patient's perspectives - Corrected Proof

Huey-Ming Tzeng — 2009-09-22

Abstract: This study triangulated the extrinsic risk factors for inpatient falls from incident reports and nurse's and patient's perspectives. Similar perspectives were shared on the patient-room-design-associated factors. Patients' concerns focused on their needs not being met in time. Fall prevention should have a priority on addressing patients' needs.

Posttraumatic stress among mothers of very low birthweight infants at 6 months after discharge from the neonatal intensive care unit - Corrected Proof

2009-09-22

Abstract: This correlational study examined how mother's posttraumatic stress disorder (PTSD) symptoms are related to characteristics of the mother and her infant, as well as to mother–infant interaction and infant development, in 21 mothers of very low birthweight infants. Twenty-three percent of mothers scored in the clinical range on a measure of PTSD. How ill the infant was during the NICU hospitalization was related to mothers' PTSD symptoms. Mothers with greater PTSD symptoms were less sensitive and effective at structuring interaction with their infant.

An exploration of nurses' perceptions regarding the implementation of a best practice guideline on the assessment and management of foot ulcers for people with diabetes - Corrected Proof

Linda Ritchie, Dawn Prentice — 2009-09-22

Abstract: The aim of this qualitative study was to explore nurses' perceptions regarding the implementation of a best practice guideline (BPG) on the assessment and management of foot ulcers for people with diabetes. Fourteen nurses from a community care setting and three hemodialysis units participated in five focus groups and one individual interview. The findings focus on key points regarding the impact of BPG implementation in the areas of patient outcomes, nursing practice, and interdisciplinary teamwork.

Precipitating factors associated with delirium among long-term care residents with dementia - Corrected Proof

Philippe Voyer, Sylvie Richard, Lise Doucet, Nancy Cyr, Pierre-Hugues Carmichael — 2009-09-22

Abstract: This cross-sectional study (N = 155) investigated precipitating factors associated with delirium among long-term-care residents with dementia and assessed their cumulative effect on the likelihood of having delirium. Use of physical restraints (odds ratio [OR] = 4.64, 95% confidence interval [CI] = 2.61–8.27) was the factor most associated, and the likelihood of being in delirium increased with the number of associated precipitating factors present (OR = 2.53, 95% CI = 1.42–4.49). Given their frailty, only a few precipitating factors need be present to increase the likelihood of these residents being in delirium, hence the need for increased nurse awareness of the risks posed by use of physical restraints with respect to the cognitive function of elderly residents with dementia.

Measuring illness uncertainty in men undergoing active surveillance for prostate cancer - Corrected Proof

2009-09-22

Abstract: Background and purpose: Uncertainty is an aversive experience and plays an important role in the lives of men undergoing active surveillance (AS; earlier referred to as watchful waiting) for early-stage prostate cancer. Yet reliable and valid measures of uncertainty have not been fully tested in this population. This secondary analysis therefore tested the reliability of the Mishel Uncertainty in Illness Scale Community Form (MUIS-C; M.H. Mishel, 1997b) for use with men undergoing AS for prostate cancer.Methods: Item–Total correlations were conducted on the 23 items of the MUIS-C with four samples of men undergoing AS.Results: Cronbach's alpha for the full MUIS-C was .908; 22 of 23 items showed significant positive correlations with the total score. Removing the item without a significant correlation from the reliability analysis increased Cronbach's alpha to .913.Conclusions: The Mishel Uncertainty in Illness Scale—Community Form for Active Surveillance is a reliable and valid tool for measuring uncertainty with men undergoing AS for prostate cancer.

Symptom management strategies used by elderly patients after coronary artery bypass surgery - Corrected Proof

Paula S. Schulz, Lani Zimmerman, Bunny Pozehl, Sue Barnason, Janet Nieveen — 2009-08-13

Abstract: The purpose of this secondary analysis was to describe symptom management strategies used by elderly patients (n = 236) 3 and 6 weeks after coronary artery bypass surgery (CABS). Three weeks after surgery, the most frequently used strategies were rest to manage shortness of breath (53%) and fatigue (53%), medications for incision pain (24%), and repositioning for swelling (35%) and sleep disturbance (18%). Overall, fewer patients experiencing sleep disturbances (39%), incision pain (39%), swelling (46%), and appetite problems (17%) reported using a strategy to manage their symptom. Nurses must assist patients in symptom identification and problem solving to accomplish effective symptom management.

The effects of an animation distraction intervention on pain response of preschool children during venipuncture - Corrected Proof

Hana Yoo, Sue Kim, Hea-Kung Hur, Hee-Soon Kim — 2009-07-16

Abstract: Objective: The purpose of this study was to identify the effects of an animation distraction intervention on pain response of preschoolers during venipuncture.Method: The research employed a nonequivalent control group pretest–posttest quasi-experimental design. The experimental group (n = 20) was provided with an animation distraction intervention using a laptop computer during their first venipuncture, and the control group (n = 20) received standard treatment.Results: There were statistically significant differences in self-reported pain response, behavioral pain response, blood cortisol, and blood glucose between the experimental group and the control group.Conclusion: This intervention requires minimum effort and time and may be a cost-effective and convenient nursing intervention that could be used easily in clinical settings.

Symptoms experienced by HIV-infected Individuals on antiretroviral therapy in KwaZulu-Natal, South Africa - Corrected Proof

2009-07-10

Abstract: Symptom management in HIV/AIDS is a critical issue that influences the quality of life of those living with the disease. Although the goals of treating the numbers living with HIV/AIDS have not yet been achieved, availability of antiretroviral therapies (ARVs) has been expanded to many clinical settings in KwaZulu-Natal, the epicenter of HIV infection in South Africa. The South African Department of Health (2007) estimates indicate that 5.54 million South Africans are living with HIV/AIDS, whereas UNAIDS (2007) estimates suggest that 18.8% of the population in South Africa is affected. Because the symptom experience may influence adherence to ARVs and quality of life, this study focused on the prevalence of symptoms reported by patients (N = 149) diagnosed with HIV/AIDS and adherence to medications and appointments. Self-report data were obtained from this community-based sample of HIV-infected patients who received care in outpatient clinics in Durban, KwaZulu-Natal, South Africa. With an average of three side effects, the most frequently reported by the study participants were fatigue/tiredness (41%), rashes (40%), headaches (32%), insomnia (31%), sadness (24%), disturbing dreams (23%), numbness (22%), pain (22%), and self-appearance (20%). On a scale of 1 to 10 (10 being worst possible), those with symptoms reported an average intensity of 4.2 (SD = 2.0), and the degree to which symptoms affected activity levels was 3.2 (SD = 2.2). Although intensity of symptoms and effects on activity levels were strongly correlated (r = .78, p < .001), there were no significant relationships between adherence and the intensity of symptoms or the relationship of symptoms with activity levels. Logistic regression analyses indicate that the presence of a greater number of symptoms was not associated with greater adherence (odds ratio = 2.27, 95% confidence interval = 0.60–8.70, ns). However, those who reported higher adherence were 1.5 times more likely to report greater physical health than low adherers (p = .04). High adherers were also 1.6 times more likely to report greater psychological health than low adherers (p = .03). This suggests that further study is needed to investigate adherence motivations for those living with HIV/AIDS in South Africa because adherence seems not to be linked to the frequency of symptoms or limitations on activity related to symptoms.

The professional self-image of registered home nurses in Flanders (Belgium): a cross-sectional questionnaire survey - Corrected Proof

2009-07-10

Abstract: Despite their necessity and relevance, studies examining the professional self-image of nurses and instruments to measure this professional self-image in the homecare setting are scarce. This study highlights both the positive self-image of home nurses and the existence of a delicate balance between the large degree of autonomy that home nurses have and the need to feel supported in their professional role and responsibility. The practice environment, including time pressure, workload, and insufficient support, needs to be addressed to keep it from having a negative impact on the professional self-image of home nurses in the long-term.

Age-related effects on symptom status and health-related quality of life in persons with HIV/AIDS - Corrected Proof

2009-07-10

Abstract: Health-related quality of life (HRQOL) is linked to symptom status and may be related to age in HIV-positive persons. Data were collected in a multisite HIV-positive sample (N = 1,217) using an HIV-specific HRQOL and three symptom status instruments according to the Wilson and Cleary HRQOL model. Multiple stepwise linear regression analysis found that younger age predicted higher sexual function (ΔR2 = .12, p < .01) and older age predicted greater provider trust (ΔR2 = .04, p < .01). No significant differences were found in symptom status or the other seven HRQOL dimensions. Although older HIV-positive persons reported more comorbidities, they did not report more symptoms.

Perspectives of staff nurses toward patient- and family-initiated call light usage and response time to call lights - Corrected Proof

Huey-Ming Tzeng — 2009-07-10

Abstract: This survey study describes nurses' perspectives about call light usage and response time. Staff perceived call lights as being patient safety related (52%) and meaningful (81.6%), and answering calls prevented them from doing the critical aspects of their role (43.8%). Staff's perspectives toward call lights should be surveyed on a regular basis.

The feasibility of Web-based surveys as a data collection tool: a process evaluation - Corrected Proof

Lesa L.K. Chizawsky, Carole A. Estabrooks, Anne E. Sales — 2009-07-10

Abstract: This study used a cross-sectional survey design with a concurrent process evaluation to examine the feasibility of using Web surveys in a population of acute care neonatal and pediatric nurses. The purpose of conducting a process evaluation was to understand if using strategies such as maximizing face-to-face communication with participants, sending reminder notices, and providing continuous support would encourage nurses to use a Web-based survey. In addition, we sought feedback about where nurses completed the survey, the number of sittings and length of time it took, and why participants that selected the print mode chose not to use the Web.

Using message framing to achieve long-term behavioral changes in persons with diabetes - Corrected Proof

Janet L. Grady, Eileen B. Entin, Elliot E. Entin, Tad T. Brunyé — 2009-07-10

Abstract: This study examines how the framing of educational information affects changes in health-related knowledge, attitudes, and behavior. Patients with diabetes viewed either a gain- or a loss-framed informational video about proper foot care and its importance for the prevention of health-threatening problems. The gain-framed messages sustained long-term positive behavioral change. Regression analyses showed that changes in attitudes were predicted by changes in knowledge and that both framing and attitudes were predictors of long-term behavior. This study is important for nurses and certified diabetes educators in that it demonstrates that gain-framed messages are effective in sustaining health-promoting behavior.

Self-directed sexually transmitted infection testing: providing noninvasive sexual health services - Corrected Proof

Patrick O'Byrne — 2009-07-10

Abstract: A literature review that addressed the possible reasons sexually transmitted infection (STI) rates are increasing indicated that self-directed STI testing for gonorrhea and chlamydia should be trialed. As such, a self-directed STI testing kit was developed and piloted for 6 months, during which 182 bathhouse patrons accessed services from both an on-site nurse and through the self-directed kits. In total, 127 of these individuals presented for testing from the nurse, with the remaining using the self-directed testing kits. Community/Participant feedback indicated that this testing method was a welcome adjunct to traditional services, thus suggesting that self-directed testing should be further explored.

Voices from the frontline: perceptions and needs of nurses involved in a nosocomial cluster of tuberculosis infection - Corrected Proof

2009-07-01

Abstract: Little is known about the psychological aspects of health care workers who contract tuberculosis (TB). This study explored the perceptions and the needs of nurses who were involved in a nosocomial cluster of TB infection in Taiwan. Using a phenomenological research design, we conducted semistructured interviews with nine participants. The data management was processed by Colaizzi's method. The result reveals that nursing staff members who occupationally contracted TB undergo two phases. From the detection of their infection to recovery, they experienced different perceptions and needs. The hospital should be mandated to accommodate nurses' varying needs accordingly. Clinical-implication-related infection control strategies, grouped into three levels of prevention, are discussed.

Clinical trial recruitment challenges with older adults with cancer - Corrected Proof

Judith K. Payne, Cristina C. Hendrix — 2009-07-01

Abstract: Older adults continue to be disproportionately represented in research studies and cancer-related clinical trials. As survival rates for patients with cancer continue to increase, it is critical that we begin to gather data on how to provide the best care to the patient population where cancer is most prevalent. The purpose of this article was to provide an overview of barriers encountered during recruitment to clinical trials of older patients with cancer. Two clinical trials involving older patients with cancer are presented to describe strategies used by the principal investigators to enhance recruitment and enrollment to their clinical research trials. These two exemplars suggest that planning and regular meetings by the research team and transparent communication are essential for successful clinical trial recruitment of older patients with cancer.

Feasibility trial of guided imagery and control interventions in mock subjects - Corrected Proof

Ann F. Jacobson, Wendy Lewandowski, Patrick A. Palmieri, Rodney P. Myerscough — 2009-07-01

Abstract: This article reports a Phase I feasibility trial of a guided imagery intervention in 20 healthy volunteers. Structural equivalence of a placebo control intervention of listening to audio book segments was evaluated. Content analysis of participant journals and exit interviews suggest suitability and acceptability of both the guided imagery and control interventions. Suggestions for their use in future clinical trials are discussed.

Illuminating hospital discharge planning: staff nurse decision making - Corrected Proof

Lori M. Rhudy, Diane E. Holland, Kathryn H. Bowles — 2009-03-27

Abstract: This qualitative study proposed to examine staff RN's decision making related to discharge planning and perceptions of their role. Themes resulting from interviews were “following the script” and “RN as coordinator.” The decision to consult a discharge planner occurred when the patient's situation did not follow the RN's expectations. Discharge planning for nonroutine situations was considered disruptive to the RN's workflow. The RN's role was limited to oversight when a discharge planner was involved. Understanding RNs' decision making in this key process provides valuable insights into differentiating routine from nonroutine patient situations and deploying appropriate resources in a timely fashion.

The pain response of infants in Turkey to vaccination in different injection sites - Corrected Proof

Ayda Celebioglu, Reva Balci Akpinar, Ayfer Tezel — 2009-01-16

Abstract: This study was carried out with the aim of comparing pain responses of children who receive intramuscular (IM) vaccination in deltoid muscle versus the pain responses of those who receive IM vaccination in the vastus lateralis. A total of 185 infants were randomly assigned to one of the two study groups. The deltoid group and the vastus lateralis group were vaccinated respectively in the deltoid muscle and the vastus lateralis. Our results indicated that pain response of infants was similar in each group. However, crying duration of the children who received the vastus lateralis vaccination was shorter than that of the deltoid group after the procedure.

Communication needs of nonspeaking hospitalized postoperative patients with head and neck cancer - Corrected Proof

Carmen S. Rodriguez, Doreen M. Blischak — 2009-01-16

Abstract: Treatment of head and neck cancers is often associated with temporary or permanent speech impairments, limiting patients' ability to self-report critical information during the acute care hospitalization period after surgery. Eleven patients unable to speak after head and neck cancer surgery, eight family caregivers, and eight RNs were included in this descriptive pilot study. All participants completed a researcher-developed 5-item survey (from their perspectives) consisting of questions that explored patients' difficulty in communicating, difficult topics to communicate, and individuals with whom patients had difficulty communicating. Study findings emphasized the importance that patients, family caregivers, and nurse assign to the communication of symptoms experienced during the acute postoperative period. In addition, the RN was identified as the health care team member with whom patients had the most communication difficulties. Findings support the participation of patients, family caregivers, and nurses in the selection and implementation of interventions that enhance communication after surgery.

Gender comparison in depressive symptoms and use of antidepressant medications after acute coronary syndrome - Corrected Proof

Nah-Mee Shin, Bonnie Hagerty, Reg Williams — 2009-01-16

Abstract: Acute coronary syndrome (ACS) affects many aspects of female and male survivors' lives. This prospective longitudinal study explored gender differences in 100 patients hospitalized with ACS and 1 month follow-up. There were no significant differences in depressive symptoms (DS) by gender. However, significantly more females than males had a history of depression and reported being prescribed and taking antidepressants. Considering that 18 nonrespondents had higher DS at Time 1 than the did the others, DS at Time 2 could have been higher given that patients who are depressed tended not to respond at Time 2. Therefore, health care providers need to pay more attention to DS in ACS survivors, especially women whose early recovery experience might be different from men.

An intervention to prevent symptoms associated with hepatitis C: a pilot study - Corrected Proof

Donna M. Zucker — 2009-01-16

Abstract: The objectives of this study were to (a) pilot test instruments measuring fatigue and quality of life (QOL); (b) pilot test an exercise intervention; and (c) estimate the effect size of this intervention relative to completion of combination therapy, fatigue, QOL, and walking distance in 20 patients with chronic hepatitis C about to begin interferon alpha and ribavirin treatment. Alpha reliabilities for both the Schwartz Cancer Fatigue Scale and Hepatitis Quality of Life Questionnaire were moderately high. Power analyses of all outcome measures indicated a small effect size and sample size estimate of 30–40 per group to achieve power of >.80.

Effects of an intervention to improve communication about end-of-life care among African Americans with chronic kidney disease: a pilot study - Corrected Proof

2009-01-16

Abstract: The prevalence of and mortality from chronic kidney disease (CKD) are high among African Americans. Interventions to improve knowledge of the likely illness course and the benefits and risks of life-sustaining treatment at the end-of-life are needed for African Americans with CKD and their surrogate decision makers. Nineteen African Americans with stage 5 CKD and their surrogates were randomized to either patient-centered advance care planning (PC-ACP) or usual care. PC-ACP dyads showed greater improvement in congruence in end-of-life treatment preferences (p < .05) and higher perceived quality of communication (p < .05) than do control dyads, but the two groups did not differ on other primary outcomes or acceptability measures, such as perceptions of cultural appropriateness. At posttest, 80% of patients in the intervention group reported that they would choose to continue all life-sustaining treatments in a situation of a low chance of survival, whereas 28.6% of patients in the control group reported that they would make that choice. At posttest, 90% of patients in the intervention group reported that they would choose to undergo cardiopulmonary resuscitation even if the chance of surviving the attempt would be low, whereas 57% of patients in the control group reported that they would make that choice. PC-ACP can be effective in improving patient and surrogate congruence in end-of-life treatment preferences. However, the results suggest a need for further improvements in the intervention to enhance cultural appropriateness for African Americans with CKD.

A randomized trial of rocking-chair motion on the effect of postoperative ileus duration in patients with cancer recovering from abdominal surgery - Corrected Proof

Robert L. Massey — 2009-01-16

Abstract: Patients who undergo abdominal surgery experience a phenomenon commonly called postoperative ileus (POI). Standard of care requires patients to get out of bed, sit in a chair, and begin ambulating the first postoperative day. No evidence supports standard care activities reduce POI duration. Rocking-chair motion has shown promise in reducing POI duration. Sixty-six participants were randomized into 2 groups. The experimental group (n = 34) received standard care plus the rocking-chair intervention; the control group (n = 32) received standard care. Participants in the experimental group had shorter duration of POI, no effect on medication use, and time to discharge.

Exploring the factors associated with hand hygiene compliance of nurses during routine clinical practice - Corrected Proof

Denise M. Korniewicz, Maher El-Masri — 2009-01-16

Abstract: Background: Nurses and other health care providers (HCPs) continue to be noncompliant with the guidelines of proper hand hygiene practices.Purpose: The purpose of this study was to explore the factors associated with hand hygiene compliance among HCPs during routine clinical.Methods: An observational study was conducted at an oncology hospital to examine hand hygiene practices observed during 612 procedures that were performed by 67 HCPs.Results: Hand hygiene compliance was 41.7% (n = 255) before procedure and 72.1% (n = 441) after the procedure. The overall compliance was only 34.3% (n = 210). Compliance with the standards of hand hygiene was higher in high-risk procedures (odds ratio [OR] = 1.77; 95% confidence interval [CI], 1.18–2.65) and when HCPs were exposed to blood (OR = 1.40; 95% CI, 1.07–1.73).Conclusion: The findings highlight the need to continue to push compliance with hand hygiene using innovative approaches that go beyond teaching and in-service training.

Effect of 16-week Kouk-Sun-Do exercise on physical fitness, emotional state, and immunoglobulin A in community-dwelling elders in Korea: A pilot study - Corrected Proof

Young Mi Lim, Gwi-Ryung Son Hong — 2009-01-16

Abstract: The purpose of this study was to determine the effects of 16-week Kouk-Sun-Do (KSD) exercise on physical fitness, emotional state, and immunoglobulin A (IgA) in community-dwelling elders in Korea. A total of 19 elders in the intervention group and 20 elders in the control group participated. The KSD exercise with low-intensity exercise was performed over a 45-minute session, three times a week for a 16-week period. The results show the effectiveness of KSD exercise on the physical fitness, emotional state, and IgA, and KSD can be identified as a feasible type of low-intensity exercise for elders. The findings suggest the need to determine clinical significance of KSD for patients in specific clinical settings; nurses with training in KSD can play a key role in implementing movement-based nursing interventions for specific health outcomes.

Are all abstracts created equal?? - Corrected Proof

Clarann Weinert — 2009-01-16

Abstract: The preparation of a strong, convincing abstract is a necessary professional skill and prized art form for nurse scientists and clinical scholars. The power and the role of an abstract are often overlooked. Abstracts are used in a variety of scholarly forums including articles submitted for publication, research proposals, and responses to “calls for abstracts” for presentations at scientific conferences. The purpose of this article is to emphasize the highlights of the “art” rather than the “cookbook” details associated with preparing an abstract. Each of the critical stages of abstract development is explored—planning, drafting, reviewing, peer reviewing, editing, and packaging. Likewise, a few, hopefully helpful, hints on developing the six key elements—background, purpose, sample, methods, results, and implications—of the scientific abstract are given. Polishing, the essential skill of preparing an abstract, takes time and persistence and will pay off in the long run. The well-crafted abstract is an initial step in the process of getting research and scholarly pursuits noticed and accepted.

Perceptions and predictions of cardiovascular disease of Alabama women in a rural county - Corrected Proof

Jenny B. Hamner, Barbara Wilder — 2009-01-16

Abstract: Purpose: The aim of this project was to gain a better understanding of cardiovascular disease (CVD) as a women's health issue among Alabama women in a rural county.Research Questions: Methods: One hundred twelve women participated in this descriptive, prospective study.Findings: Thirty percent identified CVD as the greatest health problem facing women and the leading cause of death in women. Ninety percent believed that they had a 41% or greater chance of developing CVD. The variables in the study explained 60% of the participant's coronary heart disease risk prediction scores.Conclusions: The understanding gained in this study will be used to find ways to increase the awareness of CVD and to design interventions that improve the cardiovascular health of women in a rural area of Alabama.

Jordanian surgical nurses' experiences in caring for patients with postoperative pain - Corrected Proof

Maysoon S. Abdalrahim, Sawsan A. Majali, Ingegerd Bergbom — 2009-01-16

Abstract: This qualitative study aimed to describe surgical nurses' experiences in caring for patients with postoperative pain. Twelve expert Jordanian surgical nurses participated to provide data for this study. Texts were analyzed using Kvale's guidelines for analyzing qualitative data. Five themes emerged from the texts: being faced with patients' suffering, being caught between ideals and work conditions, facing neglect and misconceptions, being confronted with families' concerns and hostility, and facing the feelings of the necessity to change. Results suggested that health care organizations need to understand and empower nurses so that effective quality care can be delivered to patients.

Small grant management in health and behavioral sciences: Lessons learned - Corrected Proof

Teresa J. Sakraida, Jessica D'Amico, Erica Thibault — 2009-01-16

Abstract: This article describes considerations in health and behavioral sciences small grant management and describes lessons learned during post-award implementation. Using the components by W. Sahlman [Sahlman, W. (1997). How to write a great business plan. Harvard Business Review, 75(4), 98–108] as a business framework, a plan was developed that included (a) building relationships with people in the research program and with external parties providing key resources, (b) establishing a perspective of opportunity for research advancement, (c) identifying the larger context of scientific culture and regulatory environment, and (d) anticipating problems with a flexible response and rewarding teamwork. Small grant management included developing a day-to-day system, building a grant/study program development plan, and initiating a marketing plan.