IU School of Nursing Works

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

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

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Now showing 1 - 10 of 780

Weight Variability, Weight Gain Goals, and Biopsychosocial Factors Among Pregnant Women
(Sage, 2024-01) Shieh, Carol; Ofner, Susan; School of Nursing
This study investigated the pattern of weight variability over 8 weeks and its associations with achieving weight gain goals and five biopsychosocial factors among pregnant women. We conducted a secondary analysis of 117 weeks of data from 16 pregnant women with a body mass index (BMI) ≥25. Weight variability was calculated from the difference of ending and beginning and maximum and minimum weights in a week and percent of each difference from baseline weight. Loess smoother, repeated measures model, and compound symmetric covariance matrix were used for analysis. The variability measure of maximum-minimum weight (overall mean: 2.1 ± 0.4 lbs.) was greater than the ending-beginning weight measure (overall mean: 0.7 ± 0.6 lbs.). Weight variability was negatively associated with achieving weight gain goals but not with biopsychosocial factors. Assessing weight variability is important during pregnancy so that preventive measures or lifestyle counseling can be instituted immediately to prevent excessive weight gain.
The impact of depression on non-pharmacological cognitive interventions in patients undergoing cardiac surgery: A systematic review
(WFCCN, 2023) Mulkey, Malissa A.; Sorrell, Anne; Savransky, Anya; Everhart, D. Erik; Wierenga, Kelly L.; School of Nursing
Background Depression is associated with cardiac-related events and cognitive dysfunction contributing to poorer health outcomes and quality of life. Specifically, after cardiac surgery, broad cognitive domains are negatively affected. To address cognitive dysfunction following cardiac surgery, researchers have tested non-pharmacological interventions with varied success. Depression is associated with worse cardiac and cognitive health outcomes yet depression’s potential contribution to interventions mitigating cognitive dysfunction following cardiac surgery is poorly understood. Aims This review aims to examine the impact of depression on the effectiveness of non-pharmacological interventions designed to minimize cognitive dysfunction associated with cardiac surgery. Methods A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Peer-reviewed articles between January 2011 to February 2022 obtained from PubMed, MEDLINE, EMBASE, Psych INFO, CINAHL, and the Web of Science databases were screened for inclusion based on predetermined criteria. Each article was screened, and data was abstracted by two authors. Results Of 8128 articles screened, 442 were assessed for eligibility and 4 met inclusion criteria. Three of the studies did not report associated depression scale scores. The other study reported depression symptoms as mild to severe. Conclusion These findings suggest limited information exists regarding the relationship between depression and cognitive function among cardiac surgery patients who undergo non-pharmacologic interventions. Future studies should carefully examine symptoms of depression in relation to cognitive impairment post-cardiac surgery; such studies may further guide clinical interventions.
Therapeutic trust in complex trauma: a unique person – centered understanding
(Taylor & Francis, 2024) Chouliara, Zoë; Murray, Jennifer; Coleman, Ann Marie; Burke Draucker, Claire; Choi, Wai Man Anna; School of Nursing
We investigated the lived experience of therapeutic trust and its ruptures in working with clients with complex trauma presentations, a vulnerable and under-researched client group. A total of 13 clinicians and key informants, working in the field of complex trauma, were interviewed. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA) to identify recurrent themes. The Nature, Function, Components, Process, and Challenges of building and maintaining therapeutic trust were identified. Therapeutic trust was experienced as a mechanism for reducing threat, processing vulnerability, and enabling accurately symbolisation. Focusing on trust and its ruptures seems key in working with clients presenting with complex traumas and potentially other severe and/or complex presentations. The importance of trust-focused person-centred approaches for addressing key psychological challenges, increasing engagement, and addressing experiences of disengagement in complex trauma is stressed. The central role of trust in the therapeutic relationship as a catalyst of change brings person- centred models to the fore of psychotherapy for complex trauma, as well as severe and/or complex presentations. In a traumatogenic world, therapists will be increasingly called to work with more clients presenting with traumas. A person-centred understanding seems to hold a lot of promise. Strategies for actively facilitating trust – focused, practice are proposed.
The Experience of Peripheral Neuropathy Symptoms in Breast Cancer Survivors With Diabetes
(Wolters Kluwer, 2024-07) Storey, Susan; Draucker, Claire; Haunert, Laura; Von Ah, Diane; School of Nursing
Background Diabetes (type 2) is a risk factor for developing peripheral neuropathy (PN) symptoms in breast cancer survivors (BCS). Because PN symptoms are associated with deficits in physical functioning and quality of life, more information is needed about the effects of PN symptoms on the lives of BCS with diabetes. Objective The aim of this study was to describe the experiences of PN among BCS with diabetes from their own perspectives. Interventions/Methods This substudy is part of a larger investigation examining factors associated with cancer-related cognitive impairment in cancer survivors. Female early-stage (stage I–III) BCS with diabetes and PN symptoms were eligible to participate. A qualitative descriptive approach using purposive sampling and semistructured interviews was used. Participant narratives were summarized using standard content analytic techniques. Results Eleven BCS with diabetes and PN symptoms were interviewed. Participants described PN symptoms that were varied, were often persistent, and had troublesome effects on their physical functioning and quality of life. Participants used a variety of self-management strategies and prescription and over-the-counter medications to manage their PN symptoms. Some said that having both cancer and diabetes exacerbated the PN symptoms and complicated symptom management. Conclusion Peripheral neuropathy symptoms can have a profound effect on the lives of BCS with diabetes and should be addressed by healthcare providers.
Description of an Audio-Based Paced Respiration Intervention for Vasomotor Symptoms
(IAMM, 2013) Burns, Debra S.; Drews, Michael R.; Carpenter, Janet S.; School of Nursing
Millions of women experience menopause-related hot flashes or flushes that may have a negative effect on their quality of life. Hormone therapy is an effective treatment, however, it may be contraindicated or unacceptable for some women based on previous health complications or an undesirable risk-benefit ratio. Side effects and the unacceptability of hormone therapy have created a need for behavioral interventions to reduce hot flashes. A variety of complex, multimodal behavioral, relaxation-based interventions have been studied with women (n = 88) and showed generally favorable results. However, currently extensive resource commitments reduce the translation of these interventions into standard care. Slow, deep breathing is a common component in most interventions and may be the active ingredient leading to reduced hot flashes. This article describes the content of an audio-based program designed to teach paced breathing to reduce hot flashes. Intervention content was based on skills training theory and music entrainment. The audio intervention provides an efficient way to deliver a breathing intervention that may be beneficial to other clinical populations.
Raising the Level of Awareness of Nurse-to-Nurse Lateral Violence in a Critical Access Hospital
(Hindawi, 2013) Embree, Jennifer L.; Bruner, Deborah A.; White, Ann; School of Nursing
Background/Significance of Problem. Nurse-to-nurse lateral violence (NNLV) has been internationally reported for greater than two decades and results in new nurse turnover and serious negative outcomes. Clinical Question/Project Objective. Will NNLV and cognitive rehearsal (CR) education result in a decrease in perceived nurse-to-nurse lateral violence in a critical access hospital (CAH)? The scope of this project was to determine perceived extent and increase awareness of NNLV through an educational project about NNLV and CR. Clinical Appraisal of Literature/Best Evidence. Trends of NNLV were assessed through an extensive literature review from Health Source, CINAHL, ProQuest Health, and Medical Complete. An educational forum about NNLV with CR was advocated for newly licensed nurses and current nurses (potential perpetrators of NNLV) with the goal of liberation of oppressed individuals. Integration into Practice/Discussion of Results. An interventional study with one group and pre-/postintervention was used to determine NNLV and CR education on perceived levels of lateral violence. Evidence-based measurement occurred through use of the Nurse Workplace Scale and the Silencing the Self-Work Scale. Outcomes were analyzed quantitatively through independent t-tests. Awareness of NNLV was increased. Evaluation of Evidence-Based Practice/Implications. Organizations must learn to eliminate NNLV. With increased levels of awareness of NNLV, nurses requested additional assistance in dealing with inappropriate behavior.
Engaging Nurses in Research for a Randomized Clinical Trial of a Behavioral Health Intervention
(Hindawi, 2013) Roll, Lona; Stegenga, Kristin; Hendricks-Ferguson, Verna; Barnes, Yvonne J.; Cherven, Brooke; Docherty, Sharron L.; Robb, Sheri L.; Haase, Joan E.; School of Nursing
Nurse involvement in research is essential to the expansion of nursing science and improved care for patients. The research participation challenges encountered by nurses providing direct care (direct care nurses) include balancing patient care demands with research, adjusting to fluctuating staff and patient volumes, working with interdisciplinary personnel, and feeling comfortable with their knowledge of the research process. The purpose of this paper is to describe efforts to engage nurses in research for the Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study. SMART was an NIH-funded, multisite, randomized, behavioral clinical trial of a music therapy intervention for adolescents/young adults (AYA) undergoing stem cell transplant for an oncology condition. The study was conducted at 8 sites by a large multidisciplinary team that included direct care nurses, advanced practice nurses, and nurse researchers, as well as board-certified music therapists, clinical research coordinators, and physicians. Efforts to include direct care nurses in the conduct of this study fostered mutual respect across disciplines in both academic and clinical settings.
What are key characteristics of adults with advanced heart failure discharged from ICU?
(Wiley, 2024-05) Edmiston, Elizabeth A.; Hardin, Heather K.; Dolansky, Mary A.; School of Nursing
Background As the number of people with heart failure and treatment complexity increases, many hospitals are implementing Advanced Heart Failure Intensive Care Units (AHFICU). However, little evidence concerning the clinical characteristics of people admitted to AHFICUs exists. Understanding the clinical characteristics of people admitted to the AHFICU will assist nurses with implementing tailored interventions to ensure high-quality care delivery. Aim The purpose of this study was to describe the clinical characteristics of people who are admitted to and discharged from an AHFICU. Study Design Baseline data from a longitudinal descriptive study were collected on adults (N = 43) admitted to an AHFICU. Heart failure severity, self-management ability, cognition, sleep quality, and other clinical characteristics were assessed. Results Most study participants were New York Heart Association functional class IV (n = 24) or class III (n = 14), indicating poor functional capacity. Over half had mild cognitive impairment and poor sleep quality was prevalent (92.7%). Participants had adequate levels of heart failure knowledge, but low levels of heart failure self-management decision-making and ability. Conclusions Interventions to address the unique clinical characteristics of AHFICU patients include sleep hygiene, integration of cognitive, sleep, and self-management assessments into the electronic medical record. Addressing the unique clinical needs of people with heart failure will lead to patient-centered, evidence-based, and safe care.
A 4-Site Public Deliberation Project on the Acceptability of Youth Self-Consent in Biomedical HIV Prevention Trials: Assessment of Facilitator Fidelity to Key Principles
(JMIR, 2025-02-13) Draucker, Claire Burke; Carrión, Andrés; Ott, Mary A.; Hicks, Ariel I.; Knopf, Amelia; School of Nursing
Background: Public deliberation is an approach used to engage persons with diverse perspectives in discussions and decision-making about issues affecting the public that are controversial or value laden. Because experts have identified the need to evaluate facilitator performance, our research team developed a framework to assess the fidelity of facilitator remarks to key principles of public deliberation. Objective: This report describes how the framework was used to assess facilitator fidelity in a 4-site public deliberation project on the acceptability of minor self-consent in biomedical HIV prevention research. Methods: A total of 88 individuals participated in 4 deliberation sessions held in 4 cities throughout the United States. The sessions, facilitated by 18 team members, were recorded and transcribed verbatim. Facilitator remarks were highlighted, and predetermined coding rules were used to code the remarks to 1 of 6 principles of quality deliberations. A variety of display tables were used to organize the codes and calculate the number of facilitator remarks that were consistent or inconsistent with each principle during each session across all sites. A content analysis was conducted on the remarks to describe how facilitator remarks aligned or failed to align with each principle. Results: In total, 735 remarks were coded to one of the principles; 516 (70.2%) were coded as consistent with a principle, and 219 (29.8%) were coded as inconsistent. A total of 185 remarks were coded to the principle of equal participation (n=138, 74.6% as consistent; n=185, 25.4% as inconsistent), 158 were coded to expression of diverse opinions (n=110, 69.6% as consistent; n=48, 30.4% as inconsistent), 27 were coded to respect for others (n=27, 100% as consistent), 24 were coded to adoption of a societal perspective (n=11, 46% as consistent; n=13, 54% as inconsistent), 99 were coded to reasoned justification of ideas (n=81, 82% as consistent; n=18, 18% as inconsistent), and 242 were coded to compromise or movement toward consensus (n=149, 61.6% as consistent; n=93, 38.4% as inconsistent). Therefore, the counts provided affirmation that most of the facilitator remarks were aligned with the principles of deliberation, suggesting good facilitator fidelity. By considering how the remarks aligned or failed to align with the principles, areas where facilitator fidelity can be strengthened were identified. The results indicated that facilitators should focus more on encouraging quieter members to participate, refraining from expressing personal opinions, promoting the adoption of a societal perspective and reasoned justification of opinions, and inviting deliberants to articulate their areas of common ground. Conclusions: The results provide an example of how a framework for assessing facilitator fidelity was used in a 4-site deliberation project. The framework will be refined to better address issues related to balancing personal and public perspectives, managing plurality, and mitigating social inequalities.
Physical Activity Programming for Older Adults in Assisted Living: Residents’ Perspectives
(Sage, 2023) Webster, Katelyn E.; Seng, Julia S.; Gallagher, Nancy A.; Gothe, Neha P.; Colabianchi, Natalie; Lavoie Smith, Ellen M.; Ploutz-Snyder, Robert; Larson, Janet L.; School of Nursing
Decreasing sedentary behavior and increasing light physical activity could promote the maintenance of functional abilities for older adults in assisted living (AL). The purpose of this qualitative study was to gather residents' recommendations about a proposed self-efficacy enhancing intervention to replace sedentary behavior with light physical activity. We interviewed 20 residents (mean age 83.1; 60% women). Topics included their current activities and thoughts about physical activity. We presented the intervention and asked questions to inform its modification. Data were analyzed with content and thematic analysis. Specific recommendations included shorter one-hour sessions and framing the intervention as increasing light physical activity rather than decreasing sedentary behavior. The thematic analysis identified multiple factors that could influence intervention implementation, including motivation to be active, safety concerns, ageist attitudes about physical activity, varying abilities of residents, social influences, and limited opportunities for physical activity. These results will inform physical activity intervention implementation for AL residents.

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