IU Indianapolis ScholarWorks :: Browsing by Author "Shieh, Carol"

Browsing by Author "Shieh, Carol"

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Association of Self-Efficacy and Self-Regulation with Nutrition and Exercise Behaviors in a Community Sample of Adults
(Taylor and Francis, 2015-11) Shieh, Carol; Weaver, Michael T.; Hanna, Kathleen M.; Newsome, Kathleen; Mogos, Mulubrhan; IU School of Nursing
This study examined the association of self-efficacy and self-regulation with nutrition and exercise behaviors. The study used a cross-sectional design and included 108 participants (54 men, 54 women). Nutrition behaviors (fruit/vegetable consumption, dinner cooking, and restaurant eating) and exercise were measured using total days in last week a behavior was reported. Instruments measuring self-efficacy and self-regulation demonstrated excellent Cronbach’s alphas (.93–.95). Path analysis indicated only fruit/vegetable consumption and exercise were associated with self-efficacy and self-regulation. Self-regulation showed direct association with fruit/vegetable consumption and exercise, but self-efficacy had direct association only with exercise. Self-efficacy and self-regulation should be strategically used to promote health behaviors.
Care Experiences of Women Who Used Opioids and Experienced Fetal or Infant Loss
(Elsevier, 2017-11) Scott, Lisa F.; Shieh, Carol; Umoren, Rachel A.; Conard, Teri; School of Nursing
Objective To explore care experiences of women who used prescription or illicit opioids and experienced fetal or infant loss. Design A qualitative, descriptive design with secondary data analysis. Setting The Fetal and Infant Mortality Review program in an urban Midwestern county in the United States. Participants Eleven women with histories of prescription or illicit opioid use who experienced fetal or infant loss participated in the semistructured telephone or in-person interview portion of the mortality case review. Methods We used thematic analysis to analyze interview data. Results Five themes were identified related to the care experiences of participants throughout pregnancy and fetal/infant loss: Frustration and anger related to not being heard, feeling minimalized; Being overwhelmed with attempts to process and understand medical complications and outcomes; Profound sense of grief and coping with loss; Need to understand why and make difficult decisions; and Placing blame and guilt over death. Conclusion Our findings suggest that women who use opioids and experience fetal or infant loss have complex care, educational, and emotional needs. In the development of interventions for these women, it is important to address their unique and complex circumstances.
Comparisons in Perceived Importance of and Needs for Maternal Gestational Weight Information Between African American and Caucasian Pregnant Women
(Springer, 2011) Shieh, Carol; Weaver, Michael T.
This study compared the perceived importance of and needs for maternal gestational weight information between African American and Caucasian pregnant women. A secondary analysis of data from 113 pregnant women (82 African Americans and 31 Caucasians) attending an inner-city prenatal clinic was conducted for this study. Perceived importance of and needs for information were measured in five areas: (1) nutrition, (2) prenatal vitamins, (3) rest/activity balance, (4) exercise, and (5) appropriate weight gain. African American women demonstrated significantly higher perceived importance of and needs for information on rest/activity balance and appropriate weight gain than Caucasian women. Exercise information was rated lower in importance but was most needed by both African American and Caucasian women. Education programs about maternal gestational weight need to be cognizant of ethnic women’s needs.
Depressive Symptoms and Obesity/Weight Gain Factors Among Black and Hispanic Pregnant Women
(Taylor & Francis, 2014) Shieh, Carol; Wu, Jingwei
This study examined the relationships between depressive symptoms and obesity/weight gain factors in 56 Black and Hispanic pregnant women and the differences in these variables between the 2 ethnic groups. Of the women, 32% were likely depressed, 66% were overweight/obese, and 45% gained excessive gestational weight. Depressive symptoms were positively correlated with prepregnancy body mass index (BMI; r = .268, p = .046), inversely related to gestational weight gain (r = –.329, p = .013), and not associated with excessive gestational weight gain. Black women were more likely to have excessive gestational weight gain than Hispanic women. Prepregnancy BMI and gestational weight gain data can be useful in identifying pregnant women with depression.
Development and Interim Evaluation of WeCare Indiana: a Community-tailored Text Messaging Intervention to Reduce Infant Mortality in East Central Indiana
(Office of the Vice Chancellor for Research, 2015-04-17) Gelarden, I.A.; Shieh, Carol; Clark, J.L.; Fry, S.J.; Smithson, G.E.; Thomas, R.R.; Umoren, R.A.
Background: Text messaging is an effective way to distribute health information and reduce risky health behaviors.1,2 In 2014, the East Central Indiana Fetal and Infant Mortality Program of the Delaware County Health Department developed a community-based text messaging intervention program called “WeCare Indiana” as an innovative approach to promote positive pregnancy outcomes. This abstract reports the interim evaluation of health promotional text messages for prenatal clients. Methods: The program was developed using a community-collaborative model. Over 200 prenatal and infant health text messages were reviewed and evaluated by community representatives. Messages included information regarding fetal and infant development, health promotion, and risk prevention strategies with links to local resources. Prenatal messages were then reviewed by prenatal clients for their relevance, clarity, and likelihood to change healthrelated behavior during pregnancy. The program was promoted locally and currently has 98 enrollees. A 4-month interim program evaluation was developed to assess program awareness, reasons for enrolling or not enrolling, and overall satisfaction with text message content. A convenience sample of prenatal clients at a Federally Qualified Health Center participated in the evaluation process. Results: Of the 43 prenatal clients that participated, 10 (23%) clients had heard about the health messaging service. Of those participants, 6 (60%) had chosen to enroll in the program. Enrollees reported hearing about the program through word of mouth, posters, fliers, health care providers, and social media. Reasons given for not enrolling included lack of awareness or interest, technical difficulties, and procrastination. All enrollees reported that the messages were helpful. Conclusions: An effort to reduce fetal and infant mortality in East Central Indiana led to the development and evaluation of community-tailored health messages. The evaluation results will be used to encourage client awareness and enrollment in the program.
Effect of acupressure on postpartum low back pain, salivary cortisol, physical limitations, and depression: a randomized controlled pilot study
(2020-02) Cheng, Hsuesh-Yu; Shieh, Carol; Wu, Bei-Yu; Cheng, Yu-Fen; School of Nursing
Objective: To investigate the effect of acupressure on postpartum low back pain (LBP), salivary cortisol, physical limitations, and postpartum depression. Methods: Participants were 70 postpartum women who were randomly assigned to either an intervention (n = 35) or a control (n = 35) group. The intervention group received 10 acupressure sessions (1 session per day, 5 d per week). The control group received 10 sham acupressure sessions. Outcomes were assessed using a visual analogue scale (LBP intensity), salivary cortisol values (LBP biomarker), and Chinese versions of the Roland-Morris Disability Questionnaire (daily activity limitations), Oswestry Disability Index (physical activity limitations), and the Edinburgh Postnatal Depression Scale (postpartum depression). Results: Participants in the intervention group had significantly lower levels of LBP intensity, daily activity limitations, physical activity limitations, and postpartum depression than those in the control group. There was no significant between-group difference in salivary cortisol. Conclusion: Acupressure may reduce postpartum LBP intensity and limitations in daily and physical activity, and alleviate postpartum depressive symptoms. Acupressure should be offered in postpartum care settings as an alternative treatment for postpartum women with LBP.
Engagement design in studies on pregnancy and infant health using social media: Systematic review
(Elsevier, 2020-05-08) Shieh, Carol; Khan, Israt; Umoren, Rachel; School of Nursing
Social media utilization is prevalent among reproductive-age women. The literature on how researchers engage women in studies using social media platforms is scarce. This systematic review analyzed participant engagement design in studies using social media and focused on pregnancy and infant health. Methods: A literature search of EBSCO and PubMed databases was conducted. Included studies had to be completed with quantitative data, focus on pregnancy, postpartum or infant health, and use social media in the research process. A matrix of three engagement designs (passive, interactive, independent) and three research processes (recruitment, data analysis, intervention) was used for analysis. Findings: Thirty-one articles that reported 30 studies met the inclusion criteria. Of these, four were randomized controlled trials (RCT), four were non-RCT interventions, and 22 were observational/descriptive studies. The main purpose of using social media was for recruitment (n = 16), data analysis (n = 6), intervention (n = 8), or both recruitment and intervention (n = 1). Passive engagement was a fundamental design approach in all studies to access a data source that was either the participant or the data provided by the participants in social media. Interactive engagement, mostly for recruitment and intervention, was to engage participants in completing study enrollment or in interacting with the study team or fellow participants. Independent engagement involved off-line activities and appeared sporadically in intervention studies. Conclusions: Passive and interactive engagement designs are more frequently used than independent engagement design. Researchers should select suitable designs when studying pregnancy and infant health using social media.
Examination of the Informed Consent Process as Experienced by Patients Who Underwent a De Novo Transjugular Intrahepatic Portosystemic Shunt, Chemoembolization or Radioembolization Procedure
(2019-08) Hughes-Gay, Marsha A.; Draucker, Claire; Belcher, Anne; Jones, Josette; Shieh, Carol
The purpose of this study is to examine the informed consent (IC) procedure as it was experienced by patients who had undergone a de novo transjugular intrahepatic portosystemic shunt (TIPS), chemoembolization (TACE), or radioembolization (TARE) procedure in an Interventional Radiology (IR) Department. The three main study aims and a fourth exploratory aim are as follows: (1) Describe how patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department described the IC procedure; (2) Describe what information patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department recalled being told during the IC procedure; (3) Describe the satisfaction of patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department with the IC procedure; and (4) Explore how the IC experiences of patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department differed according to their levels of health literacy. Using a qualitative descriptive design, participants were recruited from an IR department that performed these procedures. A total of 14 participants were interviewed about their IC experiences and the Newest Vital Sign (NVS) Health Literacy assessment was administered. The participants described the IC procedure by discussing the staff they encountered, their feelings during the visit, the support persons who accompanied them, and the decisions they made about the procedure. The participants recalled being told about how their procedure would be performed, the care they would need, and the benefits and risks of the procedure. Most were satisfied with the information received during the IC procedure and found the information consistent with how they experienced the procedure. A few participants would have liked more visual materials, addition details about the procedure, simpler language, or more explanation of the medical terminology. No apparent differences in the IC experience could be attributed to health literacy. These findings suggest that persons’ experiences during the IC process are multi-faceted and affected by their emotions and concerns and the nature of their encounters with their healthcare providers.
Experience of Maternal Narcotics Users with Fetal and Infant Loss throughout the Infant Life Cycle
(Office of the Vice Chancellor for Research, 2016-04-08) Scott, Lisa Fath; Shieh, Carol; Umoren, Rachel A.; Conard, Teri
Objective: Fetal or infant loss is a painful and traumatic experience for all mothers. Literature, however, has been limited in describing maternal experience from pregnancy to the time when a baby dies. This study explored the experience of mothers using prescribed or illicit opioids and encountering fetal or infant loss. Design: A qualitative approach using a reflexive iteration process was used to identify maternal experience across an infant’s life cycle. Participants: Eleven mothers (mostly white, single, less than a high school education) with a history of using prescribed or illicit opioids participated in the semi-structured telephone or in person maternal interview portion of the Fetal and Infant Mortality Review in a Midwest county. Methods: Interview transcripts were first coded. Codes with similar meaning were grouped into categories. Categories sharing similar features were collapsed into common themes. Each phase of analysis was performed and checked by three investigators. Results: Four common themes were identified throughout the entire life cycle of the infant: not being heard, dealing with medical complications, reproductive health, and grief, guilt and bereavement. Mothers perceived that their needs and concerns were not carefully attended to by care providers. They were overwhelmed by medical information about pregnancy and infant complications. Participants did not plan for the pregnancy or use contraception prior to the pregnancy but did use contraception in the post-partum period. Many mothers struggled with grief and loss. Additional themes included care needs for substance use and mental health and taking action and making decisions for the baby’s life. Conclusions: The findings suggest women experiencing opioid use have education and care needs when dealing with fetal/infant loss. When developing interventions for these women, clear communication about medical complications, emotional and bereavement support, and services to help these women prevent unplanned pregnancy are needed.
Experiences of Nursing Students in Caring for Patients with Behaviors Suggestive of Low Health Literacy: A Qualitative Analysis
(Sciedu Press, 2013) Shieh, Carol; Belcher, Anne E.; Habermann, Barbara
Background: Health literacy is the ability to obtain, process, and understand health information in order to take appropriate health actions. Low health literacy is associated with poor health knowledge and self-management of chronic disease, inadequate utilization of preventive services, and increased hospital admissions. The American Association of Colleges of Nursing recommends that nursing schools incorporate health literacy into curricula. Little, however, has been reported about what nursing students have learned and done about health literacy in clinical. This study explored undergraduate nursing students’ experiences in caring for patients with low health literacy. Methods: A qualitative content analysis method was used to analyze 59 narratives written by undergraduate nursing students. Results: Three themes were uncovered: sensing low health literacy by behavioral cues, promoting health literacy with multiple strategies, and closing the health information loop with positive and negative feelings. Noncompliance, knowledge deficits, anxiety/concerns, and language barriers were behavioral cues indicating low health literacy, and these cues triggered the students’ information support actions. Students promoted patient understanding and utilization of information by using many interventions: simplifying information, reinforcing information, giving written information, and demonstration/teach-back. Many students felt good about being able to help increase knowledge and self-care skills of their patients. Some were frustrated because they were unable to promote lifestyle modifications of the patients with complicated chronic diseases. Students, however, did not employ standardized tools to assess the health literacy of the patient or the patient’s knowledge of specific diseases, nor did they assess readability of patient education materials or provide patient empowerment interventions to encourage active information-seeking and participation in self-care. Conclusions: Nursing students could identify behavioral cues suggestive of low health literacy and provide solutions to increase the patient’s health literacy. To enhance student practice, nursing curricula, however, can integrate relevant health literacy assessment tools and empowerment interventions.

Browsing by Author "Shieh, Carol"

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