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Jennifer Doering, Ph.D., R.N.
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July 1, 2011
Purpose: To construct a theory of fatigue and sleep in nondepressed lower-income urban women in the 6 months after childbirth.
Design and Methods: We conducted this grounded theory study by recruiting participants from an inpatient postpartum unit in a Midwestern urban tertiary care facility. Sixteen participants, all of whom were negative for depressive symptoms, were interviewed at 1, 3, and 6 months postpartum.
Results: Participants engaged in "Persevering Toward Normalcy," in which they worked to minimize fatigue and maximize sleep by accessing flexible, dynamic social support networks, which enabled them to nap or sleep on weekends. The participants' fortitude, perseverance to "keep going" and push beyond exhaustion until their bodies "got used to" the lack of sleep and ongoing fatigue enabled them to continue working, pay rent, put food on the table, and keep children in school. At the onset of the study, participants firmly believed their fatigue would ease, and sleep would gradually improve as infant and family routines were established. Until such time, they simply needed to "deal with it."
Clinical Implications: In the early weeks postpartum, women can be taught how and when to access social support to promote sleep and prevent severe fatigue. Instruction on sleep hygiene and infant day/night entrainment may help women maximize sleep opportunities and infants establish a routine. To provide effective assistance, it is also necessary to understand the woman's individual sleep environment, as well as her socioeconomic and cultural contexts.
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Jesus (Jessie) Casida, Ph.D., R.N.
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July 1, 2011
This purpose of this study was to examine the role of nurses working in mechanical circulatory support (MCS) programs in the United States through a description of role characteristics, including demographic information, qualifications, compensation, job preparation, work setting and responsibilities, scope of practice, contributions to patient care, and organizational outcomes.
Surveys were mailed to 189 nurses at 95 MCS programs, with a response rate of 63% (n = 119). However, 11% of respondents did not meet the inclusion criteria, and thus the final sample totaled 106 participants. Results showed descriptive statistics and an analysis of contents showed many similarities among the nurses, along with some differences in work characteristics, compensation, scope of practice, and other items. The findings in this first national survey illustrate the multifaceted roles and related skill sets required of registered professional/advanced practice nurses in America’s rapidly growing MCS programs. The common use of “ventricular assist device coordinator” as job title for these specialized and highly skilled nurses is incongruent with their role in these programs. -
Elizabeth Galik, Ph.D., CRNP
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July 1, 2011
The purpose of this study was to test the feasibility and impact of function-focused care for PD (FFC-PD) developed to optimize function and physical activity among people with PD who live in the community. Parkinson's disease (PD) results in a progressive loss of function such that family caregivers provide a large percentage of the personal care to PD patients living in the home setting. This pilot study was a single-group, 2 pretest, 3 posttest repeated-measures design to investigate the impact of the FFC-PD intervention over a 12-month period. Measurements included the Self-Efficacy and Outcome Expectations for Exercise and Functional Activities, Yale Physical Activity Scale, Unified Parkinson's Disease Rating Scale, Barthel Index, Schwab & England, Timed Chair Rise, Parkinson's Disease Questionnaire-39, and Geriatric Depression Scale. The study found that Function-focused care for PD has a significant effect on increasing and on strengthening outcome expectations related to exercise, time spent in exercise and physical activity and in improving functional performance in people with PD. Further research is needed to explore the use of objective measurements of functional performance and activity and to test FFC-PD in a randomized controlled trial.
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Jennifer Wenzel, Ph.D., R.N.
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May 31, 2011
Mindfulness-based stress reduction (MBSR) programs are becoming increasingly common, but have not been studied in low income minority older populations. The purpose of this study was to understand which parts of MBSR were most important to practicing MBSR members of this population, and to understand whether they apply their training to daily challenges. There were three focus groups with 13 current members of an MBSR program. Participants were African American women over the age of 60 in a low-income housing residence. Each session was tape recorded and subsequently used inductive content analysis to identify primary themes.Analysis of the focus group responses revealed three primary themes stress management, applying mindfulness, and the social support of the group meditation. The stressors they cited using MBSR with included growing older with physical pain, medical tests, financial strain, and having grandchildren with significant mental, physical, financial or legal hardships. It was found that participants particularly used their MBSR training for coping with medical procedures, and managing both depression and anger. In conclusion, a reflective stationary intervention delivered in-residence could be an ideal mechanism to decrease stress in low-income older adult's lives and improve their health.
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Elizabeth Galik, Ph.D., CRNP
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March 14, 2011
The purpose of this study was to test reliability and validity of the Physical Resilience Scale.A single-group repeated measure design was used and 130 older adults from three different housing sites participated. Participants completed the Physical Resilience Scale, Hardy-Gill Resilience Scale, 14-item Resilience Scale, 5-item Geriatric Depression Scale, and the Yale Physical Activity Survey at baseline and again 2 weeks later. Results of this study showed evidence of validity of the Physical Resilience Scale based on model testing using a Rasch Analysis and significant correlations with commonly used general resilience measures. Evidence of reliability was supported based on a Separation Index and alpha coefficient of .89 and test-retest reliability with correlations between testing times of .73. Future use of the Physical Resilience Scale should consider adding more challenging items to better differentiate those particularly high in physical resilience.