|
|
 |
 |
 |
 |
 |
 |
 |
|
Student Research In addition to educating our future nursing leaders, we promote current research by offering students opportunities to be involved in research of interest to them. Developing the skills necessary for the discovery of new knowledge leads to new practices in the field. 2009 National Coalition of Ethnic Minority Nurse Associations (NCEMNA) Conference Presenters Congratulations to Karen Robinson for receiving the doctoral poster award! Click here to view poster Josie Veal, MSN, RN, Doctoral Student: Click here to view poster 2009 Midwest Nursing Research Society Conference Presenters Josephine M. Mancuso, PhD(c), ANP-BC: Click here to view poster Jane Morgan Nosbusch, PhD(c): Click here to view poster Karen Robinson: Click here to view poster
Additional Research and Abstracts: Factors Associated with Chinese Nurses' Perceptions of Patient Safety Culture by Xianqiong Feng Aim: To describe Chinese nurses’ perceptions of patient safety culture and associated factors. Background: Patient safety has become an important issue in global healthcare organizations. The impacts of medical errors have been widely reported. The traditional blame and shame culture in healthcare organizations has been criticized for being largely responsible for causing medical errors and obstructing the possibility of learning from those errors. However, little is known about the Chinese nurses’ perceptions of patient safety culture. Design: The study used a quantitative research methodology with a cross-sectional survey design. A total of 248 nursing managers and registered nurses from seven intensive care units and seven medical-surgical units of a Chinese university tertiary hospital participated in this study. Data were collected in September and October of 2008. Findings: Most (61.3%) of nurses positively perceived the patient safety culture. Two cultural dimensions with the highest positive response were teamwork within units and organizational learning. Four factors that found to be associated with patient safety culture: nurses’ perceived trustworthiness of their leaders, organizational safety prioritization, managers’ safety commitments, and nurses’ unit nursing experiences. There was a statistically significant difference between nursing managers and registered nurses in the perceived patient safety culture in China. Conclusion: Overall, most nurses had positive perceptions of the patient safety culture in China. Managers perceived patient safety culture more positively than staff nurses. Several factors were found to be closely associated with the patient safety culture, which has important management implications. Clinical Relevance: In order to improve the patient safety culture, nurse managers should adopt a multiple strategies and focus on factors associated with patient safety culture. Specifically, nurse mangers should try to build trust with nurses, demonstrate safety commitment, and provide adequate resources necessary for patient safety. Keywords: patient safety culture, nurses, perception, China
The Meaning of Spirituality for Elders with Dementia by Lesley Gardiner, MSN, FNP An estimated 4.5 million Americans have Alzheimer’s disease (AD) and the incidence is expected to escalate. The spiritual and religious needs of elders who have AD are often unmet by nurses and other health care professionals due to a lack of knowledge about spirituality in elders with dementia, health care providers’ discomfort in discussing religion and spirituality with clients, and educational barriers. A comprehensive and holistic approach to care is needed in nursing in order to meet the elders’ needs as a whole person - physical, mental and spiritual. The purpose of this study was to describe the meaning of spirituality and religion as experienced by elders with AD. A purposive sample of eight older adults was obtained and each was interviewed three times. Interviews were transcribed verbatim and analyzed using the Heideggerian phenomenological method. Three themes emerged from data analysis: meaning from occupations, meaning from interactions with other people, and meaning from organized religious and spiritual activities. Additional findings include insights into the effectiveness of data collection strategies including the use of music when interviewing elders with dementia. Recommendations for practice and nursing education are discussed.
Quality of Life: The Human Becoming Perspective a Descriptive Exploratory Study by Barbara J. Johnson Farmer, MSN, MSA, BSN, RN The purpose of this study, guided by Parse’s humanbecoming theory and the descriptive-exploratory design, was to uncover the meaning of quality of life as a lived experience for young African American women living with breast cancer. Breast cancer is the leading cause of cancer death in women ages 15 to 54 (American Cancer Society [ACS], 2008 & Young Survivors Coalition, 2008). Approximately 1,300 women age 40 or less will die from this disease (ACS, 2008). As a vulnerable population, young African American women experience the greatest breast cancer burden in the United States, experience the highest incidence, and have the poorest outcomes from breast cancer (ACS, 2008; National Cancer Institute, 2007). Currently, no peer-reviewed research exists regarding quality of life and young African American women. In this study, participants discussed changes in their day-to-day activities, methods of treatment, side effects, interaction with others, and living a fulfilling life. Through dwelling with the description of three themes of shared meaning, the researcher generated concepts to form the unified description of the experience of quality of life for the participants. The researcher found that quality of life is contemplating challenging times, while moving closer to and away from others in living with opportunities and restrictions while fashioning a fulfilling life amid torment. This research provides new knowledge for nursing and adds to the quality of life literature an understanding of a universal lived experience. The finding involve the participant’s hopes, dreams, and envisioning of the not-yet, as well as their participation in the day-to-day struggle of living with the now and then not-yet all-at-once when a life threatening disease and relationships pose challenges. This research expands Parse’s theory of humanbecoming in relation to quality of life. Recommendations for further research include additional research with young African American women related to quality of life and the unified description identified in this study. Conclusions and recommendations for clinical practice, academia, and future research are offered.
Loneliness, Self-Esteem, Cognition, Physical Functioning, and Nursing Home Satisfaction as Predictors of Depression by Lynn Rose Maloney, MSN, RN, ANP-BC, GNP-BC The purposes of this predictive, repeated measure, correlational study were to explore whether changes occur in loneliness, self-esteem, cognition, physical functioning, nursing home (NH) satisfaction, and depressive symptoms in older adults admitted to a NH for rehabilitation from admission to discharge and to identify whether changes in these same variables can predict the development of depressive symptoms at the time of discharge. The integration of Neuman Systems Model (NSM) with Lazarus and Folkman’s Stress, Coping, and Adaptation (SCA) Model provided the theoretical basis for the study. Study approval was obtained by Marquette University Institutional Review Board and from participating NH site administrators. A convenience sample of 29 older adults admitted to four suburban NHs for rehabilitation and meeting study criteria were included. Power analysis was conducted and assuming a= .05, it was determined that a sample size of 29 was needed to obtain 80% power. Instruments used were the UCLS Loneliness Scale, Rosenberg Self-esteem Scale, Folstein Mini-Mental State Examination, Minimum Data Set Physical Functioning Scale, Satisfaction With the Nursing Home Instrument, and the Geriatric Depression Scale. Measures of variables were obtained at NH admission + 5 days and at NH discharge or 30 days from admission + 5 days. Paired samples t-tests were conducted to determine the degree of change in variables at two points in time. Pearson’s correlational analysis was used to determine the relationships between risk factors and depression. Multiple regression analysis was used to determine whether change in variables was predictive of the variance in depressive symptoms. Significant differences in scores of self-esteem, physical functioning, and depressive symptoms were found between the time of admission and discharge. Increased age, history of depression, and comorbid thyroid disorder were associated with depressive symptoms. A model of loneliness, self-esteem, cognition, physical functioning and nursing home satisfaction was significantly predictive of depressive symptoms at discharge. Cognitive functioning accounted for 33% of the variance in total depression scores. In conclusion, changes occurred in self-esteem, physical functioning, and depressive symptoms by discharge and changes in cognitive functioning were the most predictive of depressive symptoms at discharge in this NH rehabilitation population.
The Impact of Health Literacy and Patient Trust on Glycemic Control by Josephine M. Mancuso, PhD (c), ANP-BC Problem: Diabetes with its consequence of premature death, complications, economic costs, and societal burden is antecedent to a public health crisis foreseen to worsen within several decades. Improvement of diabetic outcomes, specifically glycemic control measured by HbA1c, can impact this critical situation. Thus, establishing determinants of glycemic control is imperative. Research demonstrates that health literacy and patient trust influence health outcomes. This study examined health literacy and patient trust as predictors of glycemic control. Related factors of demographics, socioeconomic status, diabetes knowledge, self-care activities, and depression were also examined. Framework: Constructed from theory synthesis, the conceptual framework postulates that patient trust and health literacy are associated with HbA1c. Socioeconomic status and demographics influence health literacy and patient trust subsequently shaping diabetes knowledge. Diabetes knowledge is related to performance of self-care activities, which in turn, affects diabetes complications, specifically depression, thereby impacting HbA1c. Methodology: Implementing a cross-sectional, predictive design, a convenience sample of 102 uninsured diabetic patients was recruited from two urban primary care clinics. Standard multiple regression was calculated to predict the impact of health literacy, patient trust, self-care activities, diabetes knowledge, and depression on HbA1c. Correlations, requiring a corrected significance level of p<.01, were analyzed among socioeconomic status, demographics, health literacy, patient trust, diabetes knowledge, self-care activities, depression, and HbA1c. Results/Implications: The regression model was significant with patient trust and depression accounting for 28.5% of the variance in HbA1c. There was a significant positive correlation between socioeconomic status and health literacy (rho=.35), between diabetes knowledge and health literacy (rho=.30), and between depression and HbA1c (r=.34). There was a significant negative correlation between patient trust and HbA1c (rho=-.43). Results support promotion of the patient/provider relationship, depression screening within the diabetic population, and exploration of new strategies for diabetes education.
Investigating Relationships among Collaborative Behavior, RN Experience And Patients’ Perception of Discharge Teaching Quality by Jane Morgan Nosbusch, Phd (c) Collaboration is one of the primary vehicles through which hospital staff can address the extraordinary challenges present in today’s complex environments. Collaboration has the potential to reform discharge-related care processes, including patient teaching, and address many of the issues hindering the effective preparation of patients for their return home. Despite the importance of collaboration in healthcare processes, there are no published studies addressing collaboration among Registered Nurses (RNs), and very few studies investigating RN-MD collaboration in general medical-surgical units where 87% of inpatient care is provided. This investigation employed Donabedian’s framework of health care quality and Meleis’ Transition Theory to investigate relationships among collaborative behavior, both RN-RN and RN-MD, RN experience, and patients’ perception of discharge teaching quality. The patient sample was comprised of 1500 randomly selected adults hospitalized on one of 16 medical-surgical units within four acute care hospitals located in the greater metropolitan region of a Midwestern city (USA). Patient-level scores for discharge teaching quality were derived from patient responses on the Quality of Discharge Teaching Scale. Unit-level scores for collaborative behavior were obtained from a sample of 244 RNs practicing on the 16 inpatient units. RN scores on the modified Collaborative Behavior Scales- RN-MD and RN-RN were aggregated to create unit-level scores for RN-RN and RN-MD collaboration. Self-reported data were used to create unit-level scores for RN experience. Multiple regression, using data clustered by nursing unit, was employed to analyze relationships among study variables. The hypotheses that collaborative behavior and RN experience would be positively related to perceived discharge teaching quality were not supported. The small number of participating nursing units and insufficient variability among unit-level scores for collaborative behavior may have affected study results. A post hoc exploratory analysis, using a composite variable for collaborative behavior, revealed a positive and statistically significant relationship between collaborative behavior and perceived quality of discharge teaching. The findings of this exploratory study suggest that collaboration may have important implications for care delivery. These preliminary findings will inform future research investigating relationships between collaborative behavior and patient outcomes, and may have implications for health care leaders, clinicians, and researchers across settings.
Is a School-based Educational Program Effective in Changing Knowledge Regarding the Prevention of Shaken Baby Syndrome by Margaret K. Stelzel Shaken baby syndrome (SBS) involves physiological and neuropsychological sequelae secondary to parental or caregiver handling of an infant or young child (Goldberd & Goldberg, 2002). According to the American Academy of Pediatrics (AAP) (2001); non-accidental head injuries are the leading cause of traumatic death and cause of child abuse fatalities. The prognosis is extremely poor with a death rate of 26-36%; up to 78% of the survivors suffer long-term disability (Barlow, 2000). According to 2005 Wisconsin Act 165; SECTION 7.121.02(1) (L) 6 educational SBS requirements are mandated, effective school year 2007-2008. Two instrument develop studies were completed to examine reliability and validity of the SBS-13 instrument. Tenth grade students (N=260) were randomly assigned by classroom to intervention and control groups. The intervention included a 40 minute interactive class with a SBS simulator. The intervention group had significantly higher knowledge on posttest compared with the control group (p=.000). the intervention was found to be equally effective with males, of importance since they are more often the perpetrator in SBS.
Effects of Beta Blockade on Physiologic Regulation, Depressive Symptoms, & Heart Failure Severity by Kimberly A. Udlis, MSN, APRN Approximately 5 million Americans are diagnosed with chronic heart failure (CHF) each year. Despite advances in CHF treatment, mortality rates continue to rise. Compared to the general population, the coexistence of depression is high in persons with CHF. Depression is a strong predictor of morbidity and mortality in persons with CHF and is associated with higher health care costs and utilization of medical resources. Because beta (B)-blockers inhibit sympathetic nervous system (SNS) pathways, and SNS activation stimulates the expression of proinflammatory cytokines that contribute to depressive symptoms, B-blockers may inhibit cytokine-induced depressive symptoms in persons with CHF. The purpose of this study was to explore the relationship between B-blocker medication therapy and 1) autonomic nervous system activity via heart rate variability (HRV), 2) levels of proinflammatory cytokines, 3) depressive symptoms, and 4) CHF severity in persons with CHF. A convenience sample of eight subjects was enrolled in this prospective, descriptive study. Measures of HRV; plasma levels of tumor necrosis factor-alpha, interleuken-6, and brain natriuretic peptide; Beck Depression Inventory (BDI); and CHF severity, measured by the New York Heart Association HF classification and the Specific Activity Scale were evaluated prior to B-blocker medication optimization and then again after 12 weeks of B-blocker titration. Descriptive statistics demonstrated a mean BDI score of 11 indicating mild to moderate depressive symptoms within this sample. Wilcoxon’s matched-pairs signed-ranks test was used to evaluate differences in the variables pre- and post-optimal B-blocker medication titration. Trends indicating a possible improvement in the time domain measures of HRV were identified suggesting an increase in parasympathetic nervous system activity. A statistically significant decrease in depressive symptoms was found indicating improvements in depressive symptoms 12 weeks post B-blocker medication titration. No other significant findings were identified. Findings corroborate the presence of depressive symptoms in persons with CHF and provide preliminary support for national guidelines for the use of B--blocker medications in this population, while further dispelling the myth of B-blocker induced depressive symptoms. Replication of this study is warranted to fully explore the possible pathophysiological links between the ANS, proinflammatory cytokines, CHF severity, and depressive symptoms in the CHF population.
Annual Conferences National Coalition of Ethnic Minority Nurse Associations (NCEMNA) |
|
||||||
|
|
|||
|