Browsing by Author "Otte, Julie"

Now showing 1 - 5 of 5
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    The decision making process in women diagnosed with estrogen receptor-positive breast cancer experiencing side effects related to oral endocrine therapy
    (2017-02-06) Milata, Jennifer Lynn; Carpenter, Janet S.; Draucker, Claire Burke; Otte, Julie; Zimet, Greg
    Oral endocrine therapy (OET) is standard therapy for millions of estrogen receptor-positive breast cancer survivors (ER+BCS). OET reduces recurrence, mortality, and metastasis. ER+BCS often do not take their OET as recommended due to adverse side effects. The purpose of this dissertation was to develop an explanatory framework of decision making by women with ER+ breast cancer who report experiencing side effects from OET. This project was comprised of two components. The first component was a systematic review with three main findings: (1) side effects negatively impact OET non-adherence, (2) there is an absence of decisional supports provided to or available for ER+BCS who are experiencing OET side effects,, and (3) ER+BCS likely have unmet decisional needs related to OET. The second component was a grounded theory study that included 31 ER+BCS reporting OET side effects. During a single semi-structured interview, participants described the experience of OET over time. This study produced two qualitatively derived projects. First, a theoretical framework was developed that depicted four stages through which the experience of OET decision making unfolded. The stages were (1) being told what I need to do to live, (2) doing what I need to do to live, (3) enduring what I need to do to live, and (4) deciding how I want to live. Second, a typology was developed that depicted six sources of external decisional supports (healthcare providers, husbands, other breast cancer survivors, friends and family, the internet and other media sources, and God) that met four types of decisional needs (information about OET and its side effects, in-depth discussions about side effects, help in managing side effects, and emotional support). Findings can be used to develop interventions, such as decision aids, to promote quality decision making in women experiencing OET side effects.
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    Enduring Uncertainty Through the Lens of Osteoporosis: A Mixed Methods Study
    (2024-06) Vlaeminck, Caitlin Mae; Miller, Wendy Trueblood; Carter, Gregory; Crowder, Sharron J.; Otte, Julie; Longtin, Krista
    Osteoporosis is a chronic illness that is underdiagnosed and often poorly managed. Uncertainty is a phenomenon experienced by individuals diagnosed with chronic illness. There are no published American studies describing whether women diagnosed with osteoporosis experience uncertainty. Experiencing uncertainty can lead to decreased quality of life (QOL), delays in decision-making, and negative impacts on relationships. A mixed methods approach was used using descriptive statistics and two scales, The Mishel Uncertainty in Illness Scale-Community Form (MUIS-C) and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health scale, and Interpretative Phenomenological Analysis (IPA). Significant negative correlations were found between levels of uncertainty and physical health status and between physical and mental health. The qualitative study focused on describing the experience individuals had with the diagnosis of osteoporosis. Data were collected through semi-structured interviews with fourteen Caucasian women who all had a diagnosis of osteopenia or osteoporosis. Thematic analysis revealed five themes that could be chronologically processed: The Sentinel Event, Adapting to Chronic Disease, Navigating Uncertainty, Being Less Than, and What the Future Holds. The findings of this study have implications for how healthcare providers share knowledge and education about the disease of osteoporosis with individuals. Future research should include women and men from diverse racial and ethnic backgrounds. This inclusive approach is crucial for ensuring that preventive measures and management strategies are tailored to the diverse needs of all individuals, fostering equity and efficacy in osteoporosis care.
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    Hypnosis Intervention for Sleep Disturbance: Determination of Optimal Dose and Method of Delivery for Postmenopausal Women
    (T&F, 2021) Elkins, Gary; Otte, Julie; Carpenter, Janet S.; Roberts, Lynae; Jackson, Lea' S.; Kekecs, Zoltan; Patterson, Vicki; Keith, Timothy Z.; School of Nursing
    Sleep disturbances are a pervasive problem among postmenopausal women, with an estimated 40 to 64% reporting poor sleep. Hypnosis is a promising intervention for sleep disturbances. This study examined optimal dose and delivery for a manualized hypnosis intervention to improve sleep. Ninety postmenopausal women with poor sleep were randomized to 1 of 4 interventions: 5 in-person, 3 in-person, 5 phone, or 3 phone contacts. All received hypnosis audio recordings, with instructions for daily practice for 5 weeks. Feasibility measures included treatment satisfaction ratings and practice adherence. Sleep outcomes were sleep quality, objective and subjective duration, and bothersomeness of poor sleep. Results showed high treatment satisfaction, adherence, and clinically meaningful (≥ 0.5 SD) sleep improvement for all groups. Sleep quality significantly improved, p < .05, η2 = .70, with no significant differences between groups, with similar results for the other sleep outcomes across all treatment arms. Comparable results between phone and in-person groups suggest that a unique “dose” and delivery strategy is highly feasible and can have clinically meaningful impact. This study provides pilot evidence that an innovative hypnosis intervention for sleep (5 phone contacts with home practice) reduces the burden on participants while achieving maximum treatment benefit.
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    Impact of Diabetes on the Symptoms of Breast Cancer Survivors
    (ONS, 2019-07) Storey, Susan; Cohee, Andrea A.; Gathirua-Mwangi, Wambui G.; Vachon, Eric; Monahan; Otte, Julie; Stump, Timothy E.; Cella, David; Champion, Victoria; School of Nursing
    Objectives: To examine the impact of diabetes on the symptoms of women with breast cancer. Sample & Setting: 121 women with breast cancer who self-identified as having a diabetes diagnosis and 1,006 women with breast cancer without diabetes from 97 sites across the United States. Methods & Variables: Symptom scores for depression, anxiety, sexual function, peripheral neuropathy, physical function, attention function, sleep disturbance, and fatigue were compared between women with breast cancer and diabetes and women with breast cancer without diabetes, controlling for age, education, income, marital status, and body mass index (BMI). Results: Women with breast cancer and diabetes who were three to eight years postdiagnosis reported poorer physical and attention function, more sleep disturbance, and greater fatigue than women with breast cancer without diabetes. Age, education, income, and BMI were independent predictors of symptoms experienced by women with breast cancer. Implications for Nursing: Oncology nurses can assess and monitor women with breast cancer and diabetes for increased post-treatment sequelae. If problematic symptoms are identified, implementing treatment plans can decrease symptom burden and increase quality of life for women with breast cancer and diabetes.
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    Teaching Gun Violence Prevention in Undergraduate Nursing Programs
    (2023-12) Holmes, Sarah Margaret; Draucker, Claire; Moorman, Meg; Halverson, Paul; Otte, Julie; Reising, Deanna
    Gun violence is an epidemic that kills over 40,000 persons in the United States annually. Despite that gun violence is a significant public health problem, the topic is not often included in undergraduate nursing curricula. To understand this gap, the purpose of this study was to describe the teaching behaviors and perceptions of undergraduate nursing faculty related to gun violence prevention (GVP) and to explore factors that are associated with their behaviors. A survey was developed to measure faculty behaviors and perceptions. A sample of 102 nursing faculty recruited via social media communications, professional organization electronic discussion boards, and an electronic listserv completed the survey. Descriptive and inferential statistics and content analysis were used to analyze their responses. Whereas most participants were favorable to including GVP topics in curriculum, only 31 had taught about GVP in an undergraduate nursing course. Participants most frequently indicated the following topics and skills should be taught: the role of guns in unintentional injuries, suicide, and intimate partner violence; assessing for gun access; counseling about safe gun storage; and counseling about lethal means restrictions to prevent suicide. Participants indicated that key barriers to teaching about GVP included having too many other topics to teach, lack of standardized educational materials, lack of guidance from accrediting bodies, lack of faculty expertise, and the current political atmosphere. Perceived level of knowledge, level of confidence, and beliefs about teaching GVP were significantly associated with teaching GVP. The findings highlight the need for faculty development programs to increase awareness of gun violence as a public health issue and assist faculty to integrate GVP education into curricula. The findings also indicate that national nursing organizations should develop guidelines, identify competencies, and provide resources related to the inclusion of GVP content in undergraduate nursing programs.