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Pyle, Jacqueline and Scheibmeir, Monica (July 23, 2009)[more][less]
Abstract: Purpose: Maternal smoking is the greatest modifiable risk factor for the prevention of tobacco-related adverse health outcomes to both the infant and the mother. While nurses working in maternal care units are primed to deliver appropriate patient-centered communication that focuses on the skills required by pregnant women and new mothers to successfully attain smoking cessation, communicating that message is complicated by the many competing demands that nurses experience at work. The purpose of this study was to provide brief educational training to nurses on how to efficiently assess, advise, and refer pregnant women and new mothers who smoke for smoking cessation services. Theoretical Model: The theoretical model used to develop the training program was derived from the national Prescription for Change Model developed and used by interdisciplinary health care professionals. Design: This pilot study used a one-group pre-test, post-test pre-experimental design. Setting: Two maternal care units at a Midwestern University Medical Center Hospital. Participants: A convenience sample of 17 maternal child nurses. Methods: A 10 minute educational training was provided during an in-service session for the nursing staff. The educational training included information on: a) Ask, advise, and refer, and b) use of a reminder card to be used by the nursing staff. A baseline survey was given with the initial training session, and a second survey was sent out eight weeks post-training. Results: Four nursing staff completed the baseline survey and three completed the second survey. The nurses who completed the surveys were female, with a mean age of 39 years, and had worked on the unit for an average length of 5 years. Nurses reported being highly confident in their abilities at delivering tobacco cessation services. Conclusions: Issues of nurse participation in educational research identified in this study are discussed. In the future, modifications will be made to the educational training program to enhance nurses’ participation in this type of practice-based research. URI: http://hdl.handle.net/2271/759 Files in this item: 1
BSNPyle.pdf (98.93Kb) -
Myers, Sarah Elizabeth and Bott, Marjorie J. (July 23, 2009)[more][less]
Abstract: The elderly population in Kansas is growing, leading to an increased need for nursing home care. To improve the quality of life for residents and staff, many facilities have implemented care models called culture change that are focused on resident-centered care and staff empowerment. The Kansas Culture Change Instrument (KCCI) was developed using six constructs using the 2006 Commonwealth fund definition (Doty, Koran, & Sturla, 2009) as the theoretical framework. The six constructs were: resident-centered care, a homelike environment, staff/resident relationships, staff empowerment, nursing home leaderships, and quality improvement with an added seventh construct, share values. The purpose of this study was to determine: a) how leader and staff perceptions differed on the seven subscales of culture change in nursing homes; and b) whether staff and leaders scores vary differently in culture change nursing homes when compared to non-culture change nursing homes. The study is a secondary analysis using data from the Kansas Nursing Home Project. Staff and leaders employed at 100 randomly selected nursing homes in Kansas comprised the sample. The response rate was 72% (n=72). Data were collected using the KCCI. Paired t-tests and Pearson Correlations (r) were used for data analysis. The results indicated statistically (p < .01) different scores between the staff and the leaders on the total culture change score and the seven subscales Mean differences ranged from .08 to .38 on average subscales scores that ranged from 1 (never) to 4 (always). There were stronger correlations between staff and leader scores in nursing homes that had undergone extensive culture change. Collecting information from all staff and leaders in nursing homes can be time consuming and expensive. Nursing homes that had extensively implemented culture change had more consistent findings than the nursing homes that had partial or limited implementation. Consequently, it is important to assess where the nursing home is on the continuum of culture change implementation before determining who will be involved in the data collection. URI: http://hdl.handle.net/2271/758 Files in this item: 1
BSNMyers.pdf (115.5Kb) -
Mayer, Kathryn and Brewer, M. Kathleen (July 23, 2009)[more][less]
Abstract: Acculturation of immigrant Hispanic and Latina women may be directly related to their alcohol consumption. This use of alcohol may result in negative physical and psychosocial consequences. Previous research has not addressed indentifying the reasons the women use alcohol, or determined if their alcohol use is a result of acculturation, or rather serves as a means of acculturation. Understanding the reasons immigrant Hispanic and Latina women use alcohol will provide the information needed to develop specific educational interventions and programs regarding alcohol use for this population. A mixed-methods research design was used. The women were asked to complete a demographic questionnaire, the Alcohol Use Disorders Inventory Tool (AUDIT) and Short Acculturation Scale for Hispanics (SASH). In addition, participants who reported alcohol use were asked to complete a personal audio-taped interview and describe their alcohol use and reasons for choosing to drink. Surveys and interviews were provided in English or Spanish, dependent on language preference of the participant. A total of 20 women, with ages ranging from 18 years to 72 years (mean = 33 years) completed the study questionnaires. For all participants, length of time in the U.S. ranged from 0.5 years to 35 years, with a mean of 13 years. Nine of these women reported alcohol use, and four agreed to participate in an audio-taped interview. Quantitative analysis showed that women who reported alcohol use, there was a positive correlation between drinking and their level of acculturation. If the women did not drink at all, there was no relationship. Data collected in this study may be used to develop appropriate and effective interventions for this vulnerable group of women. Also, information gained has the potential to add to the scientific body of knowledge about acculturation and alcohol use among immigrant Hispanic and Latina women. URI: http://hdl.handle.net/2271/757 Files in this item: 1
BSNMayer.pdf (73.14Kb) -
Jensen, Kelsey Kay and Teel, Cynthia S. (July 23, 2009)[more][less]
Abstract: Most stroke survivors return home and rely heavily on family and friends for support. Caregiver responsibilities often are underestimated and can result in negative outcomes for the caregiver. Nurses can use specific communication elements to help caregivers improve self-care skills necessary to protect their own health, while caring for their family member. In implementing the six-session Self-Care TALK (SCT) intervention, the nurse interventionist (NI) uses four communication skills to build partnerships with caregivers. The NI: 1) listened with intent 2) affirmed emotions 3) created relational images and 4) planned enactment during the weekly SCT conversations. The SCT intervention was tested with older spouse caregivers of stroke survivors to identify how education and support conversations affect caregiver health. In this secondary analysis, the detailed NI recordings of communication skill use were analyzed to compare use across SCT sessions. Caregivers were age 55 and older, and were caring for a spouse stroke survivor. Using simple random sampling, 10 caregivers were selected from the 20 participants, yielding 60 conversation recordings for analysis. The number of recordings of each specific communication skill was identified for each participant, and totals were compared across participants and between sessions 1 and 6. The NI recording for each skill varied significantly across participants at Session 1 and Session 6. While following protocol, the NI was able to individualize the intervention for each participant. When comparing Session 1 to Session 6, the Listening skill use was significantly greater at Session 1 and there were no differences between Sessions 1 and 6 for the other 3 skills, reflecting consistency over time for skill use with each participant. Communication skill use was adapted to individual caregivers, while adhering to intervention protocol. Individualization is essential in caregiver interventions, and was reflected in the differences of skill use that were recorded across caregivers of stroke survivors. URI: http://hdl.handle.net/2271/756 Files in this item: 1
BSNJensen.pdf (79.70Kb) -
Bowden, Kasey and Smith, Carol (July 23, 2009)[more][less]
Abstract: HF patients with clinical depression are at greater risk for rehospitalization and have higher mortality rates than those without depression. The purpose of this study was to use content analysis to identify factors that patients report make them feel depressed. Fifty five study participants were screened at baseline for depression using the CES-D. A sub-sample of participants (N =37) was randomized to the intervention group and were screened for depression using the PHQ-9. Participants who scored as having moderate or severe depression on CES-D or the PHQ-9 were referred to the Psychiatric Nurse specialist for assessment (N =20). Content analysis was used to analyze the question on the CES-D: Describe what makes you feel depressed or blue. The results of the identified factors was compared with themes emerged from the nurse’s assessment. CES-D content analysis found that 69% (N =38) of participants reported experiencing depression due to: illness/health; loss of independence; financial concerns, and life stressors. Nurse’s assessments (N=20) identified themes of grief and situational depression (N =5), fatigue/insomnia (N =9), and anger reactions (N =4). Participants also disclosed concerns with concurrent psychiatric illnesses, worry over family, loneliness, and illicit drug use. Psychiatric nurse specialists can identify additional factors contributing to depression and make further treatment recommendations. The patho-physiologic effects of depression on HF suggest the need for future study in this area. URI: http://hdl.handle.net/2271/755 Files in this item: 1
BSNBowden.pdf (58.53Kb)
