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Browsing by Author "von Gaudecker, Jane R."
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Item Adolescents' qualitative expressions of functional seizure illness representation(Wiley, 2024) Tanner, Andrea L.; von Gaudecker, Jane R.; Crowder, Sharron J.; Buelow, Janice M.; Miller, Wendy R.; School of NursingIntroduction: Adolescents with functional (nonepileptic) seizures experience challenges self-managing this mental health condition, especially at school where adolescents experience stress, bullying, accusations of faking seizures, and stigma. According to the Common Sense Model of Self-Regulation, adolescents' self-management decisions and outcomes may be shaped by their functional seizure illness representation (perceptions or mental depictions formed in response to a health threat). However, current research has only explored adults' functional seizure illness representation; little is known about adolescents. The aim of this study was to explore adolescents' expressions of illness representation characteristics (identity, cause, consequence, controllability/curability, and timeline) when describing their experience attending school with functional seizures. Methods: We analyzed qualitative data from 10 adolescents (age 12-19 years, 100% female) from the United States with functional seizures. Data collection occurred in 2019 via semistructured interviews about adolescents' school experiences. The theme of illness representation emerged without prompting adolescents to discuss illness representation or its characteristics. This study involved inductive analyses and magnitude coding of adolescents' unsolicited expressions of illness representation. Results: All five characteristics of illness representation were mentioned by adolescents; however, not all characteristics were mentioned by all adolescents. Adolescents' expressions of illness representation characteristics resulted in the following descriptive themes: clashing labels and mind-body façade for identity, stress for cause, gains and losses for consequence, control/lack of control for controllability/curability, and no end of seizures in sight for timeline. Conclusions: Adolescents' expressions of illness representation reveal perceptions considered "threatening" within the Common Sense Model, especially those expressing lack of controllability/curability and condition timelines with no end in sight. The Common Sense Model offers a framework for understanding how these threatening perceptions may impact health and academic outcomes or change with intervention.Item Adolescents’ Perceptions of Functional Seizure Self-Management Strategies, Facilitators, and Barriers in the School Environment(Slack, 2023) Tanner, Andrea L.; von Gaudecker, Jane R.; Buelow, Janice M.; Oruche, Ukamaka M.; Miller, Wendy R.; School of NursingAdolescents with functional (psychogenic nonepileptic) seizures encounter many struggles within the school environment, including stress, bullying, stigmatization, and accusations of faking seizure events. Mental health nurses and school personnel are poised to support school-based self-management; unfortunately, to date, no evidence exists to detail effective school-based self-management strategies for adolescents with functional seizures. Therefore, in the current qualitative study, we examined adolescents' functional seizure self-management, perceived effectiveness, and facilitators and barriers using semi-structured interviews analyzed using content analysis. We interviewed 10 adolescent females aged 12 to 19 years. Themes of proactive (prior to seizure warning symptoms) and reactive (after seizure warning symptoms) self-management, involving protection, perseverance, and progress monitoring, emerged. Adolescents perceived proactive strategies as primarily effective, whereas reactive strategies were less effective. Adolescents identified school nurses and personnel, family, and peers as facilitators and barriers to self-management. Mental health nurses are positioned to provide care, co-create plans, and advocate for adolescents with functional seizures in collaboration with school nurses and personnel.Item Development and collaborations of a nursing workgroup within a bilateral global medical consortium(Sigma, 2020) Reid, Davika D.; von Gaudecker, Jane R.; Sila, Faith M.; Zuniga, Julie A.; Haskett, Lindsay A.; Tarus, Titus K.; Kyololo, O'Brian; Chelagat, Dinah J.; Abbyad, Christine W.; Garcia, Alexandra A.; Buelow, JaniceWe describe the formation of a bilateral nursing workgroup within a global medical consortium of North American and Kenyan healthcare providers and detail our collaboration to advance nursing care, education, and research to improve patient outcomes across a variety of specialties in acute care and community settings in both countries.Item How Older Adult Caregivers Manage Wound Care Procedures, Resources Needed, and Public Policy Implications(2022-10) Swartzell, Kristen Leigh; Fulton, Janet S.; von Gaudecker, Jane R.; Bartlett Ellis, Rebecca J.; Huber, LesaAs healthcare increasingly shifts to home and community-based settings, informal caregiver responsibilities are increasing beyond assistance with activities of daily living to include complex care procedures previously performed by licensed caregivers in clinical settings. With an aging population, increasing numbers of older adults are assuming a caregiving role, a trend that is projected to continue into the foreseeable future. These older caregivers performing complex care procedures such as wound care. The purpose of this dissertation study was to understand how older adult caregivers manage complex wound care procedures. Aims were to 1) develop a theory for how caregivers manage; 2) identify themes related to resources needed, and 3) determine resources available through the existing Medicaid 1915(c) waivers program. Aims 1 and 2 were achieved using qualitative analysis of interviews with 18 older adult caregivers aged 65 and older who were performing wound care in the home for a care recipient. Grounded theory methods were used to develop a theoretical framework describing the process of how the participants managed caregiving. The resultant theory, Pushing Through, consisted of five phases: 1) accepting the role, 2) lacking confidence, 3) creating a system, 4) trusting in self, 5) owning the outcomes. Secondary analysis of the interview data used thematic analysis methods to identify resources used or needed for the caregiver role. The resultant themes were (a) connection to a healthcare professional, (b) written instructions, (c) access to wound care supplies, (d) access to durable medical equipment, (e) financial resources, (f) personal care coverage, and (g) socialization and emotional support. Aim 3 used descriptive analysis of Medicaid 1915(c) home- and community-based services waivers for adults aged 65 and older for all 50 states plus the District of Columbia to identify the frequency and type of waiver services available for supporting caregivers. Results revealed that the number of services offered by state Medicaid waiver programs varied greatly across the country. Respite in varying forms was the most frequently available service. Findings from this dissertation will contribute to the development of evidence-based strategies to sustain older adult caregivers within their caregiving role.Item “It’s hard!”: Adolescents’ experience attending school with psychogenic nonepileptic seizures(Elsevier, 2022) Tanner, Andrea L.; von Gaudecker, Jane R.; Buelow, Janice M.; Oruche, Ukamaka M.; Miller, Wendy R.; School of NursingAdolescents with psychogenic nonepileptic seizures (PNES) face many challenges in the school setting. Researchers have identified school stressors as potential predisposing, precipitating, and perpetuating factors for PNES. However, few researchers have explored the perspectives of adolescents with PNES regarding their experiences of attending school, where they spend much of their time. Therefore, this qualitative study employed content analysis to explore the experience of attending school as an adolescent with PNES. Ten adolescents (100% female, 80% White) were interviewed. With an overwhelming response of “It’s hard!” from respondents, five themes regarding the school experience emerged: stress, bullying, accusations of “faking” seizure events, feeling left out because of the condition, and school-management of PNES. Underlying these themes were expressions of the need for increased understanding from and collaboration among peers, as well as the need for increased understanding from families, healthcare providers, and school personnel including school nurses. Study findings should inform future adolescent PNES research, practice decisions made by healthcare providers in the health and education sectors, education of healthcare and school professionals, and policy development and implementation.Item Living in the epilepsy treatment gap in rural South India: A focused ethnography of women and problems associated with stigma(Taylor & Francis, 2017) von Gaudecker, Jane R.; Taylor, Ann Gill; Keeling, Arlene W.; Buelow, Janice M.; Benjamin, Sailas; School of NursingIn India, women with epilepsy face unique challenges. A focused ethnography of six women within the epilepsy treatment gap was conducted in rural South India. Women were asked to describe their day-to-day lives. Data were collected through open-ended, semistructured interview questions, participant observation, and field notes. Thematic analysis was done. The disease-related stigma contributed to the women's physical, psychological, and emotional struggles; the women and their family members made every effort to conceal the disease. Educational interventions to create awareness could help women seek effective treatments for their seizures, thereby reducing the stigma and improving the quality of their lives.Item 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 NursingWomen 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.