Browsing by Author "Hacker, Eileen"
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Item A Systematic Review of Functional Outcomes in Cancer Rehabilitation Research(Elsevier, 2022) Sleight, Alix G.; Gerber, Lynn H.; Marshall, Timothy F.; Livinski, Alicia; Alfano, Catherine M.; Harrington, Shana; Flores, Ann Marie; Virani, Aneesha; Hu, Xiaorong; Mitchell, Sandra A.; Varedi, Mitra; Eden, Melissa; Hayek, Samah; Reigle, Beverly; Kerkman, Anya; Neves, Raquel; Jablonoski, Kathleen; Hacker, Eileen; Sun, Virginia; Newman, Robin; McDonnell, Karen Kane; L’Hotta, Allison; Schoenhals, Alana; Stout, Nicole L.; School of NursingObjective: To systematically review the evidence regarding rehabilitation interventions targeting optimal physical or cognitive function in adults with a history of cancer and describe the breadth of evidence as well as strengths and limitations across a range of functional domains. Data sources: PubMed, Cumulative Index to Nursing and Allied Health Plus, Scopus, Web of Science, and Embase. The time scope was January 2008 to April 2019. Study selection: Prospective, controlled trials including single- and multiarm cohorts investigating rehabilitative interventions for cancer survivors at any point in the continuum of care were included, if studies included a primary functional outcome measure. Secondary data analyses and pilot/feasibility studies were excluded. Full-text review identified 362 studies for inclusion. Data extraction: Extraction was performed by coauthor teams and quality and bias assessed using the American Academy of Neurology (AAN) Classification of Evidence Scheme (class I-IV). Data synthesis: Studies for which the functional primary endpoint achieved significance were categorized into 9 functional areas foundational to cancer rehabilitation: (1) quality of life (109 studies), (2) activities of daily living (61 studies), (3) fatigue (59 studies), (4) functional mobility (55 studies), (5) exercise behavior (37 studies), (6) cognition (20 studies), (7) communication (10 studies), (8) sexual function (6 studies), and (9) return to work (5 studies). Most studies were categorized as class III in quality/bias. Averaging results found within each of the functional domains, 71% of studies reported statistically significant results after cancer rehabilitation intervention(s) for at least 1 functional outcome. Conclusions: These findings provide evidence supporting the efficacy of rehabilitative interventions for individuals with a cancer history. The findings should be balanced with the understanding that many studies had moderate risk of bias and/or limitations in study quality by AAN criteria. These results may provide a foundation for future work to establish clinical practice guidelines for rehabilitative interventions across cancer disease types.Item Activities of Daily Living Recovery in Home Health Patients with Diabetes(Oxford University Press, 2023-12-21) Webster-Dekker, Katelyn; Lu, Yvonne; Perkins, Susan; Ellis, Jennifer; Otis, Laurie; Winton, Rebecca; Hacker, Eileen; School of NursingOlder adults with diabetes are at high risk for impairments in their ability to perform activities of daily living (ADLs). Home health (HH) services help patients regain their ability to perform ADLs after being hospitalized, but there may be disparities in degree of ADL improvement based on characteristics such as race/ethnicity. We aimed to identify factors associated with improvements in ADLs from the start of HH care to discharge in older adult (age ≥65) patients with diabetes receiving HH. This secondary analysis used Outcome and Assessment Information Set-D data collected between October 1, 2021, and March 31, 2022 in the Southern U.S by a HH agency. We used multiple linear regression to examine factors associated with improvement in ADL performance. The sample (n=1350) was 55% female and 76% White, with a mean age of 76.3 (SD 7.3). Ninety-seven percent of patients improved their ADL score from start of HH care to discharge. Black/African American race (b= -0.33) and having bowel incontinence or an ostomy (b= -0.51) were associated with less ADL improvement. Having a caregiver who needed training/support (b= 0.44) or was unlikely to provide assistance (b= 0.78), the presence of a surgical wound (b= 0.52), pain that interfered with activity (b= 0.46), confusion (b= 0.30), and better scores in prior functioning (b= 0.13) at the start of HH were associated with greater improvement in ADLs upon discharge from HH. These findings require further investigation, but indicate Black patients experienced disparities in ADL improvement which should be addressed.Item Associations between COVID-19 perceptions, anxiety, and depressive symptoms among adults living in the United States(2021-09) Wierenga, Kelly L.; Moore, Scott E.; Pressler, Susan; Hacker, Eileen; Perkins, SusanBackground: Associations among illness perceptions of viruses, anxiety and depression symptoms, and self-management decisions, such as mask-wearing, are critical to informing public health practices to mitigate the short- and long-term consequences of the SARS-CoV-2 viral pandemic. Purpose: Guided by the common-sense model of self-regulation, this observational study examined associations among illness perceptions of COVID-19, anxiety, and depression symptoms among community-dwelling adults. Method: Data were collected from 1380 adults living in the United States early in the pandemic (03-23-2020 to 06-02-2020). Participants completed online surveys. Analyses were conducted using descriptive statistics and correlations. Findings: While increased anxiety symptoms were associated with less perceived personal control, greater concern, and higher emotional responsiveness, increased depression symptoms were related to lower concern as well as greater emotional responsiveness and perceived consequences of the pandemic. Discussion: Associations among illness perceptions, anxiety, and depression symptoms may impact viral spread mitigation behavior adoption.Item Fatigue and Sleep Disturbance in Arabic Cancer Patients After Completion of Therapy: Prevalence, Correlates, and Association With Quality of Life(Wolters Kluwer, 2021-09) Al Maqbali, Mohammed; Hughes, Ciara; Rankin, Jane; Dunwoody, Lynn; Hacker, Eileen; Gracey, Jackie; School of NursingBackground Fatigue and sleep disturbance are 2 of the most common and distressing cancer symptoms that negatively affect quality of life. Objective The aim of this study was to assess the prevalence of, and factors contributing to, fatigue and sleep disturbance in Arabic-speaking cancer patients in Oman after completion of their cancer treatment. Methods A cross-sectional and descriptive correlational design was used. Data were collected using the Pittsburgh Sleep Quality Index where a score of >5 indicated as poorer sleep, the Functional Assessment of Cancer Therapy–Fatigue a score of ≤34 indicating clinically significant fatigue, and the Functional Assessment of Cancer Therapy–General. Results Of the 369 patients who participated, 77.5% (n = 286) reported clinically significant fatigue, and 78% (n = 288) reported poor sleep. Fatigue (P < .05) was significantly associated with age, cancer site, months since diagnosis, type of treatment received, and comorbidity. Those experiencing fatigue and poor sleep had the lowest quality of life among the cancer patients studied. Conclusion Fatigue and sleep disturbance are significant problems for the Arabic patients diagnosed with cancer. Both fatigue and sleep disturbance should be routinely assessed in the case of such patients. Implications for Practice Routine assessments of fatigue and sleep disturbance are recommended so that appropriate interventions and treatment management plans can be introduced to reduce fatigue and improve sleep quality among patients with cancer.Item Healthcare professionals knowledge on cancer-related fatigue: A cross-sectional survey in Oman(Wiley, 2020-09) Al Maqbali, Mohammed; Gracey, Jackie; Dunwoody, Lynn; Rankin, Jane; Hacker, Eileen; Hughes, Ciara; School of NursingCancer-related fatigue is a common and distressing cancer symptom that negatively affects quality of life. The main objective of this study was to determine health professionals' knowledge relating to cancer patients' fatigue in Oman and identify current management practices of cancer-related fatigue. A cross-sectional survey design using Qualtrics® software was performed. The survey had five sections and comprised 32 items. A total of 138 healthcare professionals working in Oman participated in the study (response rate 63.9%). Nearly three quarters of the participants were nurses (74.6%, n = 103). The mean level of knowledge of cancer-related fatigue was 16.6/23, with 50% of participants having the expected level of knowledge above 12. The result indicated that professional discipline and work experience each were significantly associated with overall level of knowledge. Participants identified the need for guidelines, assessment tools, and training for the oncology staff to help improve the quality of life of patients with cancer-related fatigue.Item The multidimensional kidney transplant self-management scale : development and psychometric testing(2018-04-03) Chung, Shu-Yu; Hacker, Eileen; Jones, Josette; Ellis, Rebecca Bartlett; Rawl, Susan; Bakas, TamilynPoor long-term kidney transplant outcomes are a significant problem in the U.S. Interventions must focus on preserving allograft function by managing modifiable risk factors. An instrument capable of identifying problems with post-kidney transplant self-management behaviors may enable the design and testing of self-management interventions. This study’s purpose was to test the psychometric properties of the new Kidney Transplant Self-Management Scale (KT–SM). The Zimmerman framework adapted for kidney transplant self-management guided the cross-sectional study. A total of 153 kidney recipients recruited from Facebook® completed the Self-Efficacy for Managing Chronic Disease (SEMCD), Patient Activation Measure (PAM), Kidney Transplant Questionnaire (KTQ), and KT–SM Scale instruments via a REDCap® survey. Most participants were female (65%), White (81.7%), and middle-aged (M = 46.7; SD = 12.4 years) with a history of dialysis (73%) and received a kidney transplant an average of 6.58 years previous (SD = 6.7). Exploratory factor analysis results supported the 16-item KT–SM Scale as a multidimensional scale with five domains with loadings ranging between .39 and .89: medication adherence, protecting kidney, cardiovascular risk reduction, ownership, and skin cancer prevention. Internal consistency reliability for the total scale (Cronbach’s α = .84) and five domains ranged from .71 to .83. The total and domains were positively correlated, ranging from r = .51 to .76, p = .01. Criterion-related validity was evidenced by significant correlations of KT–SM and domains with SEMCD (r =.22 to .53, p = .01), PAM (r = .31 to .52, p = .01), and the overall KTQ (r = .20 to .32, p = .01) except for one KT–SM domain: protecting kidney. Construct validity was evaluated using multivariate regression analysis. The linear combination of age, patient activation, and self-efficacy explained 45% of the variance in KT–SM behaviors; 47% of the variance in KTQ (measuring quality of life) was predicted by age, comorbidity, and self-efficacy. These findings provide beginning evidence of reliability and validity for the newly developed KT–SM scale. Instruments like this may provide a means to capture the self-management behaviors of the kidney transplant population, which is critical for future work on interventions.Item Psychometric Properties of the Arabic Version of the Functional Assessment of Chronic Illnesses Therapy–Fatigue in Arabic Cancer Patients(Elsevier, 2020-01) Al Maqbali, Mohammed; Hughes, Ciara; Gracey, Jackie; Rankin, Jane; Hacker, Eileen; Dunwoody, Lynn; School of NursingBackground The Functional Assessment of Chronic Illness Therapy (FACIT) is a measurement system that was developed to assess the health-related quality of life among patients with cancer and other chronic illnesses. The Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) is a 40-item questionnaire, and it is one of the most frequently used instruments to assess fatigue in cancer populations. The aim of this study was to evaluate the psychometric properties of the Arabic FACIT-F among patients diagnosed with cancer. Methods Following a translated and cross-cultural evaluation procedure of the FACIT-F Arabic version, a cross-sectional and descriptive correlational design was conducted. A total of 369 patients with cancer completed the FACIT-F, which consists of the 27-item Functional Assessment of Cancer Therapy–General (FACT-G) and the 13-item Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F). The scale was assessed in terms of acceptability, internal consistency, and validity. Construct validity was explored through confirmatory factor analysis. Results The FACT-G had acceptable fit in the four-factor model, whereas the FACIT-Fatigue was found to be acceptable for the one-factor model in Arabic patients diagnosed with cancer. The Cronbach's alpha coefficient for the Arabic FACIT-Fatigue was 0.92, whereas the total score for FACT-G was 0.92, which showed good reliability. There was evidence that discriminated validity analysis was generally very good for the FACIT-Fatigue and FACT-G Arabic versions. Conclusion The Arabic versions of the FACIT-Fatigue and FACT-G demonstrated good reliability and validity for assessing fatigue and quality of life in patients diagnosed with cancer.Item Risk factors for inpatient facility admission among home health care patients with diabetes(Elsevier, 2023) Webster-Dekker, Katelyn E.; Hacker, Eileen; Perkins, Susan M.; Chang, Pei-Shiun; Ellis, Jennifer; Winton, Rebecca; Otis, Laurie; Gates, Maria; Lu, Yvonne; School of NursingBackground: Home health care (HHC) patients with diabetes are at high risk for inpatient admissions. Purpose: To identify variables associated with inpatient admissions among adults age ≥50 with diabetes receiving HHC in the community and in assisted living (AL). Methods: Retrospective HHC data (collected October 2021 to March 2022 in the Southern United States) from the Outcome and Assessment Information Set D were analyzed with logistic regression (n = 5,308 patients). Discussion: The inpatient admission rate was 29.5%. For community-dwelling patients, multiple hospitalizations, depression, limited cognitive function, decreased activities of daily living (ADL) performance, and unhealed pressure ulcer or injury ≥stage 2 were significantly associated with inpatient admission. For those in AL, multiple prior hospitalizations and decreased ability to perform ADLs were associated with inpatient admission. Conclusion: Understanding risk factors for inpatient admissions among patients with diabetes can support the identification of at-risk patients and inform interventions.Item Validation of the Pittsburgh Sleep Quality Index (PSQI) with Arabic cancer patients(Springer, 2020-07) Al Maqbali, Mohammed; Hughes, Ciara; Gracey, Jackie; Rankin, Jane; Dunwoody, Lynn; Hacker, Eileen; School of NursingThe Pittsburgh Sleep Quality Index (PSQI), a self-administrated questionnaire, is a frequently used instrument to assess sleep quality in clinical and non-clinical populations. The aim of the study was to evaluate the psychometric properties of the Arabic PSQI among patients diagnosed with cancer. A cross-sectional and descriptive correlational design was used with 369 patients with cancer completing the 19-item Arabic version of the PSQI. The scale was assessed in terms of acceptability, internal consistency and validity. The Cronbach’s alpha coefficient for the Arabic PSQI was 0.77, demonstrating acceptable reliability. The global PSQI score did not have floor or ceiling effects. The PSQI Arabic version demonstrated good discriminative validity. Construct validity was explored by confirmatory factor analysis to examine the dimensional structure of the PSQI. The confirmatory factor analysis showed an acceptable fit for refined one-factor model. The results support the original single factor structure of the PSQI. The Arabic version of the PSQI demonstrated adequate reliability and validity for assessing sleep quality in Arabic-speaking patients diagnosed with cancer.