IU School of Nursing Works

Permanent URI for this collection

https://hdl.handle.net/1805/8325

Scholarship (articles, conference presentations, reports, posters and proceedings) by IU School of Nursing faculty, staff and students.

Browse

Now showing 1 - 10 of 721

Physicians' and nurses' perspectives on increased family reports of pain in dying hospitalized patients
(2000) Hickman, Susan E.; Tolle, Susan W.; Tilden, Virginia P.
Many indicators suggest that care of the dying in Oregon has been improving over the past decade. However, results from a recent study suggest that one aspect of care of the dying, pain management, may be worsening. In late 1997, family reports of moderate and severe pain in dying hospitalized patients increased from 33% to 57%. This occurred during a volatile time in the Oregon political climate associated with events surrounding a second vote on physician-assisted suicide. In order to better understand the observed increase better, a statewide sample of physicians and nurses was surveyed to obtain their opinions about factors that may have contributed to the increased family reports of moderate and severe pain in dying hospitalized patients. Seventy-nine percent of respondents endorsed two or more factors as partial explanations. These factors include an increase in family expectations about pain management (endorsed by 96%), decreased physician prescribing (endorsed by 66%), and reduced nurse administration of pain medication (endorsed by 59%). Physicians who thought reduced physician prescribing was a partial factor rated fears of the Board of Medical Examiners and the Drug Enforcement Administration as the most likely explanations for decreased prescribing. More research is needed to better understand family expectations for end-of-life care, fears of investigation, and pain medication practices.
Trends in opioid use over time: 1997 to 1999
(2004-02) Tolle, Susan W.; Hickman, Susan E.; Tilden, Virginia P.; Bubalo, Joseph S.; Fromme, Erik K.
Substantial resources have been spent to improve pain control for dying patients, and increased opioid administration has been presumed. Oregon has been a consistent leading state in per capita use for morphine for the past 10 years, as recorded by the Automation of Reports and Consolidated Orders System (ARCOS). Health policy experts, extrapolating from World Health Organization methods, have suggested these data are indicative of the quality of end-of-life care in Oregon. To determine whether trends in opioid prescription at the state and national levels reflect increased opioid use for inpatients during the final week of life, chart reviews were conducted to record all opioid medications administered in the last week of life to 877 adult inpatients who died from natural causes between January 1, 1997 and December 31, 1999. Inpatient morphine use did not increase significantly for dying patients from 1997 to 1999. However, overall morphine use for both Oregon and the United States as measured by ARCOS data increased significantly. Comparisons revealed no significant difference between linear trends for Oregon and U.S. morphine use, but both were significantly greater than the dying inpatients. This pattern was also found for all other opioids. These findings suggest that ARCOS data do not necessarily provide information about opioid use for specific subpopulations of patients and raise questions about the meaning of observed increases in ARCOS data.
Family Health Needs Study: Bi-National Community Participatory Research
(2006-04-07T18:56:57Z) Riner, ME
Third lecture in a series: International Research Ethics. March 29, 2006. Lecture I.
Depressed mood in informal caregivers of individuals with mild cognitive impairment
(Sage, 2007) Lu, Yueh-Feng Yvonne; Austrom, Mary Guerriero; Perkins, Susan M.; Bakas, Tamilyn; Farlow, Martin R.; He, Feng; Jin, Shelia; Gamst, Anthony; School of Nursing
This study estimates the prevalence of depressed mood in caregivers of individuals with mild cognitive impairment (MCI) and assesses whether demographics, stressors, intrapsychic strain, and gain are associated with depressed mood. A secondary analysis of baseline data from the Alzheimer's Disease Cooperative Study MCI trial was conducted using a cross-sectional, correlational design. Descriptive statistics to estimate the prevalence of caregiver depressed mood and univariate and block-wise logistic regression analyses were used. The prevalence of depressed mood in 769 caregivers was 24.6% (95% confidence interval, 21.5-27.7). The odds of being depressed were significantly higher in younger, nonspousal caregivers with less education, who cared for MCI patients with lower activities of daily living functioning, and who perceived greater relational deprivation, higher levels of self-loss, and personal gain. Controlling for relevant variables, relational deprivation and caregiver education continued to be significantly associated with depressed mood. Relational deprivation may be important for future interventions.
Post-Stroke Depression: Focus on Diagnosis and Management during Stroke Rehabilitation
(2007-09) Johnson, Elizabeth A; Bakas, Tamilyn; Williams, Linda S.
Post-Stroke Depression: Focus on Diagnosis and Management during Stroke Rehabilitation. Geriatrics & Aging. 10(8):492–6.
Administrators' perspectives on ethical issues in long-term care research
(2008) Hickman, Susan E.; Cartwright, Juliana C.; Young, Heather M.
ETHICAL ISSUES ARE A SIGNIFICANT potential barrier to much-needed research in long-term care settings. LTC stakeholder perspectives are largely absent from the development of regulation and guidelines. Fifteen long-term care administrators were interviewed as part of a study of ethical issues in community-based, long-term care research. Established qualitative procedures for conducting content analysis were used to organize the data. Findings suggest that existing mechanisms to protect human subjects do not take into account important differences between academic and long-term care settings. The full potential of LTC research will not be realized until supportive processes to enhance human subjects protections are developed in a way that is reflective of the LTC environment.
A Synergistic Dialogue: Clinical Nurses and Academic Researchers in Partnership
(Elsevier, 2008-02-01) Barnes, Y.J.; Hendricks-Ferguson, V.L.; Oakley, B.; Roll, L.; Stegenga, K.; Haase, J.E.; School of Nursing
A Randomized Trial of Two Print Interventions to Increase Colon Cancer Screening Among First-Degree Relatives
(2008-05) Rawl, Susan M.; Champion, Victoria L.; Scott, Linda L; Zhou, Honghong; Monahan, Patrick; Ding, Yan; Loehrer, Patrick; Skinner, Celette Sugg
First-degree relatives (FDRs) of people diagnosed with colorectal cancer (CRC) have a two- to threefold increased risk of developing the same disease. Tailored print interventions based on behavior change theories have demonstrated considerable promise in facilitating health-promoting behaviors. This study compared the impact of two mailed print interventions on CRC screening outcomes among FDRs. Methods This randomized trial compared effects of two mailed print interventions – one tailored and one nontailored – on participation in CRC screening among FDRs of CRC survivors. Data collected via phone interviews from 140 FDRs at baseline, 1 week post-intervention, and 3 months post-intervention. Results At 3 months, both the tailored and nontailored interventions yielded modest but statistically insignificant increases in adherence to any CRC screening test (14% vs. 21%, respectively; p = 0.30). While there were no main effects for tailored versus nontailored interventions, there were significant interactions that showed that the tailored print intervention had significantly greater effects on forward stage movement for CRC screening depending on stage of adoption at baseline, race, and objective CRC risk. Receipt of the tailored intervention was 2.5 times more likely to move baseline precontemplators and contemplators forward in stage of adoption for colonoscopy (95% CI: 1.10–5.68) and was three times more likely to move Caucasians forward in stage of adoption for FOBT (95% CI: 1.00–9.07). In addition, the tailored intervention was 7.7 times more likely to move people at average risk forward in stage of adoption for colonoscopy (95% CI: 1.25–47.75). Conclusion The tailored print intervention was more effective at moving Caucasians, those in precontemplation and contemplation at baseline, and those at average risk forward in their stage of adoption for CRC screening. Practice implications Both tailored and nontailored print interventions showed moderate effects for increasing CRC screening participation. Tailored print interventions may be more effective for certain subgroups.
Oncology Outpatient and Provider Responses to a Computerized Symptom Assessment System
(2008-07) Carpenter, Janet S.; Rawl, Susan M.; Porter, Jennifer; Schmidt, Karen; Tornatta, Jennifer; Ojewole, Foluso; Helft, Paul; Potter, David A; Sweeney, Christopher; Giesler, R. Brian
Purpose/Objectives: To assess patient and provider responses to a computerized symptom assessment system. Design: Descriptive, longitudinal study with retrospective, longitudinal medical records review. Setting: University-based National Cancer Institute-designated outpatient cancer center. Sample: 80 oncology outpatients receiving chemotherapy, 8 providers, and 30 medical records. Methods: Patients completed the computerized assessment during three chemotherapy follow-up clinic appointments (times 1, 2, and 3). Patient usability was recorded via an observer checklist (ease of use) and the computer (completion time). Patient satisfaction and impact were assessed during telephone interviews two to three days after times 1 and 3 only. Provider usability and impact were assessed at the end of the study using a questionnaire and focus groups, whereas effect on provider documentation was assessed through chart audits. Main Research Variables: Patient usability (ease of use, completion time), satisfaction, and impact; provider usability and impact. Findings: Patients reported good usability, high satisfaction, and modest impact on discussions with their providers. Providers reported modest usability, modest impact on discussions with patients, and had varied reactions as to how the system affected practice. Documentation of symptoms was largely absent before and after implementation. Conclusions: This system demonstrated good usability and satisfaction but had only a modest impact on symptom-related discussions and no impact on documentation. Implications for Nursing: A computerized system can help address barriers to symptom assessment but may not improve documentation unless it can be integrated into existing medical records systems.
Content Validity and Satisfaction With a Stroke Caregiver Intervention Program
(Wiley, 2009) Bakas, Tamilyn; Farran, Carol J.; Austin, Joan K.; Given, Barbara A.; Johnson, Elizabeth A.; Williams, Linda S.; School of Nursing
Background and Purpose Establishing evidence of content validity and satisfaction is an integral part of intervention research. The purpose of this article is to describe content validity and satisfaction relative to the Telephone Assessment and Skill-Building Kit (TASK), an 8-week follow-up program based on individualized assessment of stroke caregiver needs. Design and Methods The TASK intervention enables caregivers to develop skills based on assessment of their own needs. During the development of the TASK program, 10 experts rated the validity of the TASK intervention components for accuracy, feasibility, acceptability, and problem relevance. After incorporating feedback from the experts, a randomized controlled clinical trial was instituted using a convenience sample of 40 stroke caregivers to determine satisfaction (usefulness, case of use, and acceptability) with the TASK intervention (n=21) compared with an attention control group (n=19). Data collection occurred between March 2005 and June 2006. Data were analyzed using descriptive statistics, independent sample t tests, and content analysis. Findings Expert ratings on a 1 to 5 scale, with 5 being strongly agree, provided evidence of content validity (accuracy 4.71, feasibility 4.46, acceptability 4.40, problem relevance 4.67). Caregivers in the TASK group scored significantly higher than the attention control group on all satisfaction measures (usefulness p=.02; ease of use p=.02; acceptability p=.05). Qualitative comments from caregivers provided further evidence of satisfaction. Conclusions Evidence of content validity and user satisfaction for the TASK intervention relative to an attention control group was found. Clinical Relevance The TASK program may be a viable telephone-based program that can be implemented by nurses to support family caregivers during the first few months after stroke survivors are discharged home.

Browse

Browsing IU School of Nursing Works by Issue Date

Results Per Page

Sort Options