IU Indianapolis ScholarWorks :: Browsing by Author "Draucker, Claire B."

Browsing by Author "Draucker, Claire B."

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The experience of post-craniotomy pain among persons with brain tumors
(2018-04-16) Foust, Rebecca Elizabeth; Von Ah, Diane M.; Draucker, Claire B.; Carpenter, Janet S.; Kroenke, Kurt; Stone, Cynthia
Post-craniotomy brain tumor patients often experience pain in the post-surgical period which can negatively affect recovery and surgical outcomes. Research with this population has focused on pharmacological treatments of post-craniotomy pain and measurement of pain intensity. Little is known about how these patients experience the quality of their pain and how this pain is managed. The purpose of this dissertation was to provide an in-depth description of the experience of post-craniotomy pain during the post-surgical period. The information gained about how post-craniotomy patients experience pain and pain management will contribute the development of effective, tailored interventions to enhance patient satisfaction and outcomes. This dissertation project was composed of two components. The first component was an integrative review of literature examining the evidence of pain and associated symptoms in adult (aged 21 and older), post-craniotomy brain tumor patients. The review examined studies from the past fourteen years that focused on the incidence and treatment of postcraniotomy pain. It revealed that the majority of post-craniotomy patients experience moderate to severe pain after surgery. This pain is associated with nausea, vomiting, changes in blood pressure, and increased length of hospital stay. The second component was a qualitative descriptive study of a sample of 28 adult (aged 21 and older) post-craniotomy patients hospitalized on an inpatient neurosurgical stepdown unit at a Midwestern urban teaching hospital. During semi-structured interviews, participants described their experiences of post-craniotomy pain and of their experiences of postcraniotomy pain management. Data generated from the qualitative descriptive study were analyzed and resulted in two qualitatively derived products. The first was a description of participants’ experiences of the quality of their post-craniotomy pain during the post-surgical period. The six types of pain quality described were pain as pressure, pain as tender or sore, pain as stabbing, pain as throbbing, pain as jarring, and pain as itching. The second was a description of how post-craniotomy patients experience the management of their pain during the post-surgical period. The four groups of types of pain management experiences described were pain-as-non-salient, routine pain management; pain-as-non-salient, complex pain management; pain-as-salient, routine pain management; and pain-as-salient, complex pain management.
Pain Management Experiences Among Hospitalized Postcraniotomy Brain Tumor Patients
(Wolters Kluwer, 2021) Foust Winton, Rebecca E.; Draucker, Claire B.; Von Ah, Diane; School of Nursing
Background: Brain tumors account for the majority of central nervous system tumors, and most are removed by craniotomies. Many postcraniotomy patients experience moderate or severe pain after surgery, but patient perspectives on their experiences with pain management in the hospital have not been well described. Objective: The aim of this study was to describe how patients who have undergone a craniotomy for brain tumor removal experience pain management while hospitalized. Methods: Qualitative descriptive methods using semistructured interviews were conducted with patients on a neurological step-down unit in an urban teaching hospital in the Midwest United States. Interviews focused on how patients experienced postcraniotomy pain and how it was managed. Narratives were analyzed with standard content analytic procedures. Results: Twenty-seven participants (median age, 58.5 years; interquartile range, 26-41 years; range, 21-83 years) were interviewed. The majority were white (n = 25) and female (n = 15) and had an anterior craniotomy (n = 25) with sedation (n = 17). Their pain experiences varied on 2 dimensions: salience of pain during recovery and complexity of pain management. Based on these dimensions, 3 distinct types of pain management experiences were identified: (1) pain-as-nonsalient, routine pain management experience; (2) pain-as-salient, routine pain management experience; and (3) pain-as-salient, complex pain management experience. Conclusions: Many postcraniotomy patients experience their pain as tolerable and/or pain management as satisfying and effective; others experience pain and pain management as challenging. Implications for practice: Clinicians should be attuned to needs of patients with complex pain management experiences and should incorporate good patient/clinician communication.
Pain Quality Among Hospitalized Postcraniotomy Brain Tumor Patients
(Wolters Kluwer, 2021) Foust Winton, Rebecca E.; Draucker, Claire B.; Von Ah, Diane; School of Nursing
Purpose/aims: The aim of this study was to describe how persons given a diagnosis of a brain tumor who have had a craniotomy describe the quality of their pain after surgery. Design: A qualitative descriptive design was used. Methods: Qualitative descriptive methods as described by Sandelowski guided this study. Semistructured interviews were conducted with patients hospitalized on a neurological step-down unit in an urban teaching hospital in the Midwestern United States. Interviews focused on the quality of participants' pain after surgery. Narratives were analyzed using standard content analysis. Results: Twenty-seven participants were interviewed. Most were White and female. Most underwent a craniotomy using an anterior approach with sedation. Participants described the quality of their pain with 6 different types of descriptors: pain as pressure, pain as tender or sore, pain as stabbing, pain as throbbing, pain as jarring, and pain as itching. Conclusions: Participants' descriptions of their pain quality after surgery provide a different understanding than do numerical pain ratings. Clinicians should use questions to explore patients' individual pain experiences, seeking to understand the quality of patients' pain and their perceptions.
Post-Craniotomy Pain in the Brain Tumor Patient: An Integrative Review
(Wiley, 2016-06) Guilkey, Rebecca Elizabeth Foust; Von Ah, Diane; Carpenter, Janet; Stone, Cynthia; Draucker, Claire B.; Department of Nursing, IU School of Nursing
Aim To conduct an integrative review to examine evidence of pain and associated symptoms in adult (≥21 years of age), postcraniotomy, brain tumour patients hospitalized on intensive care units. Background Healthcare providers believe craniotomies are less painful than other surgical procedures. Understanding how postcraniotomy pain unfolds over time will help inform patient care and aid in future research and policy development. Design Systematic literature search to identify relevant literature. Information abstracted using the Theory of Unpleasant Symptoms’ concepts of influencing factors, symptom clusters and patient performance. Inclusion criteria were indexed, peer-reviewed, full-length, English-language articles. Keywords were ‘traumatic brain injury’, ‘pain, post-operative’, ‘brain injuries’, ‘postoperative pain’, ‘craniotomy’, ‘decompressive craniectomy’ and ‘trephining’. Data sources Medline, OVID, PubMed and CINAHL databases from 2000–2014. Review method Cooper's five-stage integrative review method was used to assess and synthesize literature. Results The search yielded 115 manuscripts, with 26 meeting inclusion criteria. Most studies were randomized, controlled trials conducted outside of the United States. All tested pharmacological pain interventions. Postcraniotomy brain tumour pain was well-documented and associated with nausea, vomiting and changes in blood pressure, and it impacted the patient's length of hospital stay, but there was no consensus for how best to treat such pain. Conclusion The Theory of Unpleasant Symptoms provided structure to the search. Postcraniotomy pain is experienced by patients, but associated symptoms and impact on patient performance remain poorly understood. Further research is needed to improve understanding and management of postcraniotomy pain in this population.
“Quick Flutter Skip”: Midlife Women’s Descriptions of Palpitations
(Wolters Kluwer, 2023) Carpenter, Janet S.; Fagan, Rileigh; Alzahrani, Mofareh A.; Jaynes, Heather A.; Tisdale, James E.; Kovacs, Richard J.; Chen, Chen X.; Draucker, Claire B.; School of Nursing
Objective: The objective of this study is to describe peri- and postmenopausal women's experiences of palpitations (quality, frequency, severity, distress, duration and temporal pattern, aura, associated symptoms, and aggravating/alleviating factors) and related healthcare experiences. Methods: Qualitative descriptive methods were used. Semistructured interviews were conducted with women who reported palpitations and were enrolled in a larger case-control pilot study comparing electrocardiographic results between women with and without palpitations. Authors analyzed women's narratives using standard content analytic procedures. Results: Fourteen participants (mean age, 54.5 y [SD = 4.8 y]; range, 46-62 y; 79% postmenopausal) completed interviews. The interviews revealed that women (a) often had difficulty describing their palpitations until prompted by the interviewer; (b) experienced noteworthy variations in the quality and other dimensions of their palpitations; (c) had a wide variety of healthcare experiences related to their palpitations, including not reporting their symptoms to providers, having providers dismiss their symptoms, and having providers be aware of their symptoms and provide diagnostic tests; and (d) at times, created worst case scenarios (downward shifts) under which they would seek treatment for their palpitations, thus enabling them to minimize their symptoms and avoid healthcare. Conclusion: This study advances understanding of how women describe their palpitations and related healthcare experiences. Findings could have implications for building research and clinical tools to guide assessment, communication, and/or education for patients and/or providers about palpitations and for developing and testing behavioral interventions to address this poorly understood symptom in peri- and postmenopausal women.
Reasons women do not seek health care for dysmenorrhea
(Wiley, 2017) Chen, Chen X.; Shieh, Carol; Draucker, Claire B.; Carpenter, Janet S.; School of Nursing
Aims and objectives The purpose of this study was to identify and describe reasons women do not seek health care for dysmenorrhea symptoms. Background Although dysmenorrhea is highly prevalent among women, can cause significant disruptions in their daily lives, and may increase their risk for future chronic pain conditions, few women seek health care for dysmenorrhea. A better understanding of why women do not seek health care is necessary to develop strategies that facilitate care seeking and optimal symptom management. Design A Qualitative Descriptive design was used to guide the study and summarize text responses to an open-ended survey question. Methods Participants in an online survey study who had not sought health care for dysmenorrhea (N=509) were asked to write about their reasons for not seeking care. Data were collected in January and February 2015. Participants’ text responses were analyzed using qualitative content analysis. Results Nine categories of reasons were identified: assuming symptoms are normal, preferring to self-manage symptoms, having limited resources, thinking providers would not offer help, being unaware of treatment options, considering symptoms to be tolerable, being wary of available treatments, feeling embarrassed or afraid to seek care, and not seeking health care generally. Conclusions Findings can guide the development of strategies to promote care seeking and inform policy and clinical practice to improve dysmenorrhea management. Relevance to clinical practice Findings underscore the need to provide routine screening for dysmenorrhea, avoid dismissing dysmenorrhea symptoms, initiate discussions and provide education about dysmenorrhea, provide treatments options based on evidence and women's preferences, and raise public awareness of dysmenorrhea and its impact.
A study of Indiana University Health's spirit of inquiry and innovation during COVID
(Elsevier, 2021-07) Carpenter, Janet S.; Draucker, Claire B.; Bartlett Ellis, Rebecca J.; Ferren, Melora D.; Gilbert, Jason H.; Newhouse, Robin P.; Von Ah, Diane; School of Nursing
Background COVID-19 has required nursing innovations to meet patient care needs not previously encountered. Purpose The purpose of this study was to describe nursing innovations conceived, implemented, and desired during the first COVID-19 surge. Methods The investigators invited registered nurses employed across 16 Midwest hospitals (6,207) to complete the survey. Respondents provided demographics and written descriptions of innovations they conceived, witnessed, and desired. Investigators analyzed text responses using standard content analytic procedures and summarized quantitative demographics using percentages. Findings Nurses reported seven types of innovations that would (a) improve personal protective equipment (PPE), (b) limit the need to repeatedly don and doff PPE, (c) ensure safer practice, (d) conserve and access supplies, (e) provide patient and family education and support, (f) make team member communication more efficient, and (g) improve peer support. Discussion Nurses are in a unique position to generate innovative solutions to meet patient care needs under adverse and rapidly changing situations.
What women say about their dysmenorrhea: a qualitative thematic analysis
(BioMed Central, 2018-03-02) Chen, Chen X.; Draucker, Claire B.; Carpenter, Janet S.; School of Nursing
Background Dysmenorrhea is highly prevalent and is the leading cause of absence from school and work among women of reproductive age. Evidence suggests that dysmenorrhea may also be a risk factor for other chronic pain conditions. Limited research has examined women’s experience with dysmenorrhea using qualitative data. Research is warranted to address issues and needs that are important from women’s own perspectives. Therefore, the purpose of this study was to describe women’s salient thoughts about their experiences of dysmenorrhea. Methods We analyzed data collected from an open-ended question within a cross-sectional survey study conducted in the United States. Using qualitative thematic analysis, free text responses to a question asking women to share their experience with dysmenorrhea were analyzed. Results The sample consisted of 225 women who provided valid responses to the open-ended question. Six themes were identified: (1) The dysmenorrhea symptom experience varied among women; (2) The dysmenorrhea symptom experience varied across time, (3) A variety of factors influenced the dysmenorrhea symptom experience, (4) Dysmenorrhea symptoms could have a negative impact on the women’s daily lives, (5) Dysmenorrhea was not seen as a legitimate health issue by the women, health care providers, or society, and (6) Treatment for women with dysmenorrhea varied in acceptability and effectiveness. Conclusions The findings of this study have important implications for dysmenorrhea symptom assessment and the development of personalized interventions to support dysmenorrhea management.
Women’s Experiences with Epilepsy Treatment in Southern India: A Focused Ethnography
(NSU, 2019) von Gaudecker, Jane R.; Taylor, Ann Gill; Buelow, Janice M.; Benjamin, Sailas; Draucker, Claire B.; School of Nursing
Women with epilepsy in rural southern India often do not receive anti-epilepsy drugs (AEDs) or take these drugs regularly, but little is known about how they experience the epilepsy treatment they do receive. The purpose of this study was to provide an in-depth description of the treatment experiences of women in this region who had been diagnosed with epilepsy but who do not consistently take AEDs. Focused ethnography was conducted using participant observation and in-depth interviews with six women with epilepsy, eight of their family members, and two traditional healers. The women's treatment experiences are best described as living at the intersection of Western allopathic ("English") medicine and traditional healing practices-approaches that could be complementary or conflicting. The women revealed a variety of perceived barriers to the use of "English" medicine. Health care professionals should appreciate the dynamic interplay of the two treatment approaches and consider all cultural, social, and economic factors that influence the women's treatment experiences.

Browsing by Author "Draucker, Claire B."

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