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Browsing by Author "Cullen, Deborah"
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Item Addressing Disparity: What Aspects of African American Culture Contribute to an Increased Risk for Sudden Unexpected Infant Death (SUID)?(Office of the Vice Chancellor for Research, 2015-04-17) Ayres, Brook; Fauvergue, Cheyenne; Cullen, Deborah; Stiffler, DeborahIntroduction: African American infants in the United States were 2.4 times more likely to die in the first year of life than white infants. In Indiana, the 2013 overall Infant Mortality Rate was 7.2, but the rate for African Americans was 15.3. Non-breast feeding mothers, sleep positioning, sleep surface, bed sharing, and learning barriers among African American mothers suggest differences in outcomes as compared with infants born in white families. This systematic review of the literature focuses on the corollary variables between SUID and African American culture, specifically what puts African American babies at an increased risk for dying. Methods: A rigorous multi-database search was conducted using key words SUID, African American Culture. Originally we accessed 217 articles. Of these 217 articles, we found fifteen qualitative articles and 28 quantitative articles that met our inclusion criteria of being between the years 1990-2015 and had a specific link between African American culture and SUID. We will be using the System for the Unified Management, Assessment and Review of Information (SUMARI) through the Joanna Briggs Institute. Two tools, the Qualitative Assessment and Review Instrument (QARI) and Meta-Analysis of Statistics Assessment Review Instruments (MASTARI) will carry out the validity, reliability and data extraction. Results: Preliminary themes suggest that breast-feeding, sleep positioning, and sleep surface, bed sharing, and learning barriers may contribute to the SUID disparity among African Americans. Conclusion: Further investigation may prove useful in determining what interventions could be placed in practice to decrease SUID in black infants. Health care professionals need to be aware of the disparity when developing their approach to care for African American infants and their families.Item Do Service Dogs Improve Safety and Quality of Life in Children with Disabilities?(Office of the Vice Chancellor for Research, 2014-04-11) Wilson, Jessica; Cullen, DeborahAlthough the use of service dogs is not a new concept, the practice of service dog intervention to improve safety and quality of life is relatively novel. Research studies have described that service dogs aided a decrease in overall arousal and enhanced a dramatic increase in expressive language for a child with autism. Notably children were more focused and attentive as well as laughed more after dog sessions. Since the sample sizes of service dog studies are small, a meta-synthesis of research articles relating to dogs assistance for safety and improvement in quality of life for disabled children was conducted. The purpose of doing a meta-synthesis is to explore studies with the same phenomenon of interest and compare and contrast the findings while describing the phenomenon. A rigorous methodological protocol was used for this meta-synthesis as described by the Joanna Briggs Institute. The online software Narrative Opinion Text Assessment and Review Instrument (NOTARI) developed by the Joanna Briggs Institute permitted the authors to evaluate and engage with 22 studies to determine quality, credibility and outcomes. Findings, in the form of themes, are entered with an illustration of the participants’ voice. These themes were further evaluated and aggregated to represent an interpretive meta-synthesis. One meta-synthesized theme found across the research was improved family quality of life. This is illustrated, for example, as dog-calming and promoting less problematic behavior as well as decrease in the stress response allowing the child body to relax. A second meta-synthesized theme of safety emerged as dogs are tethered to the children with autism to keep them from bolting. Parents felt that the child was safe with the service dog by the child’s side. These findings have robust clinical recommendations which may significantly impact families and disabled children.Item Globally, What Affects Primary Caregivers’ Grieving Processes Leading To Subsequent Effective And Ineffective Coping Strategies Following An Infant Mortality.(Office of the Vice Chancellor for Research, 2015-04-17) Birch, Nicole R.; Campbell, Hailey N.; Cullen, Deborah; Stiffler, DeborahWorldwide in 2013, 4.6 million infant deaths occurred within the first year of life and accounted for 74% of all deaths under the age of 5 years old. As a result of these infant death events, there are varied zcaregiver grief responses and coping strategies. The purpose of this study was to meta-synthesize what factors affect primary caregiver grieving processes and then analyze their effective and ineffective coping strategies. After a rigorous multi-database search, we accessed 9 articles worldwide from years 1995-2013 for inclusion. These 9 papers were assessed for credibility by a primary and secondary reviewer via standardized critical appraisal instruments from the Joanna Briggs Institute. Data extraction and metaaggregation of the findings was carried out to determine intergenerational coping strategies and grieving process after an infant death. Eight peer reviewed articles were included in the aggregation. The data extracted included specific details about intergenerational support, interrelationship support, and lasting emotional impressions following an infant death. We identified that the influence of living children and parents of the primary caregivers are significant sources of intergenerational support. Conversely there is a lack of support between primary caregivers leading to incomplete coping and grieving processes within the relationship. Furthermore, lasting emotional impressions were acknowledged as a recurrent theme among individuals affected by the loss of an infant. Nursing interventions and education should be identified that address caregiver and family member grieving processes and coping strategies such as follow up emotional coping assessments at regular intervals for those at risk for poor coping. Nurses have the ability to play a vital role in improving the family and caregiver outcomes including positive coping strategies and healthy grieving processes following infant mortality.Item Implementation of an evidence-based seizure algorithm in intellectual disability nursing: A pilot study(2016) Auberry, Kathy; Cullen, DeborahBased on the results of the Surrogate Decision-Making Self Efficacy Scale (Lopez, 2009), this study sought to determine if nurses working in the field of intellectual disability experience increased confidence when they implemented the “American Association of Neuroscience Nurses Seizure Algorithm” during telephone triage. The results of the study indicated using the AANN Seizure Algorithm increased self-confidence for many of the nurses in guiding care decisions during telephone triage. The treatment effect was statistically significant -3.169, p, .01 for a small sample of study participants. This increase in confidence is clinically essential for two reasons. Many individuals with intellectual disability and epilepsy reside within community based settings. Intellectual disability nurses provide seizure guidance to this population living in community based settings via telephone triage. Nurses improved confidence is clinically essential and has implications for practice. Evidenced-based training tools provide a valuable mechanism by guiding nurses via best practices. Nurses may need to be formally trained for seizure management due to high epilepsy rates in this population.Item A Synthesis of Coping Experiences After Infant Death(Wolters Kluwer, 2017-03) Stiffler, Deborah; Birch, Nicole; Campbell, Hailey; Cullen, Deborah; School of NursingThe purpose of this article was to synthesize qualitative research data that examine parental coping strategies following infant death. This qualitative synthesis found that parents who effectively cope with the death of their infant would continue the bond with the deceased child, have differences in the way they manage their emotions about the loss, and have intergenerational support in the form of family being present, acknowledging the death, performing immediate tasks, and providing helpful information. Nurses should be vigilant to ensure parents receive “memories” of their infant after an in-hospital death. Knowledge of the coping process can assist nurses and clinicians to better care and support parents following an infant death and, in turn, facilitate the healing process.Item Telephone triage and seizure management for community-based ID/DD: A research synthesis(Sciedu, 2017) Auberry, Kathy; Cullen, Deborah; Luna, Gaye; School of NursingNurse and physician clinicians often guide seizure care for individuals with intellectual and developmental disability (ID/DD) through telephone triage. This article evaluated the evidence for epilepsy management tools with a focus on the telephone triage tool. Studies were included in the systematic review, data was extracted, followed by meta-aggregated findings. A rigorous methodological protocol was used as described by The Cochrane Collaboration. All quantitative or descriptive studies that included epilepsy management tools or protocols for persons with ID/DD living in a community-based setting were considered. No tools specific to ID/DD seizure management via telephone triage were discovered. Study results reveal a possible gap in clinical care. Research findings did support the use of telephone triage tools and epilepsy protocols for clinicians. These findings may improve seizure management by focusing ID/DD clinicians on the advantages of using such tools. Findings may also illuminate the need for seizure management tools specific to the ID/DD population.Item When Baby Stops Breathing: Analysis of Parents’ Interviews(2019) Stiffler, Deborah; Cullen, Deborah; Stephenson, Evelyn; Luna, Gaye; Hartman, TaylorSudden unexplained infant death (SUID) is responsible for 14% of Indiana’s infant mortality (ISDH, 2015a). The purpose of this qualitative research study was to describe parents’ experiences when death of an infant occurred suddenly and unexpectedly. Field deputies or social workers interviewed mothers or fathers from central Indiana during the child-death team investigations. The Thematic Analysis Program (TAP) from the Joanna Briggs Institute (JBI) was used to analyze interview data. Seventeen de-identified interview cases were extracted, and a meta-aggregate method was conducted. The three synthesized themes were Extreme Emotional Shock, We Feel Like We're to Blame, and Working Toward Moving On. Understanding these phenomena from mothers’ experience may assist in eliminating risks associated with infant deaths and inform nursing practice and policy.