Beverly R. Williams

Bio: Beverly R. Williams is an academic researcher from University of Alabama at Birmingham. The author has contributed to research in topics: Palliative care & Veterans Affairs. The author has an hindex of 18, co-authored 81 publications receiving 1214 citations. Previous affiliations of Beverly R. Williams include Veterans Health Administration & United States Department of Veterans Affairs.

Barriers to mobility during hospitalization from the perspectives of older patients and their nurses and physicians.

Abstract: BACKGROUND Low mobility is common during hospitalization and is associated with adverse outcomes. Understanding barriers to the maintenance or improvement of mobility is important to the development of successful interventions. OBJECTIVES To identify barriers to mobility during hospitalization from the perspectives of older patients and their primary nurses and physicians, to compare and contrast the perceived barriers among these groups, and to make a conceptual model. DESIGN Qualitative interviews analyzed and interpreted using a grounded theory approach. SETTING Medical wards of a university hospital. PARTICIPANTS Twenty-nine participants—10 patients ≥ 75 years, 10 nurses, and 9 resident physicians. MEASUREMENTS Participants were interviewed using a semistructured interview guide, with similar questions for patients and health care providers. Interviews were audiotaped, transcribed, and reviewed for common themes by independent reviewers. Perceived barriers to mobility were identified, and their nature and frequency were examined for each respondent group. RESULTS Content analysis identified 31 perceived barriers to increased mobility during hospitalization. Barriers most frequently described by all 3 groups were: having symptoms (97%), especially weakness (59%), pain (55%), and fatigue (34%); having an intravenous line (69%) or urinary catheter (59%); and being concerned about falls (79%). Lack of staff to assist with out-of-bed activity was mentioned by patients (20%), nurses (70%), and physicians (67%). Unlike patients, health care providers attributed low mobility among hospitalized older adults to lack of patient motivation and lack of ambulatory devices. CONCLUSIONS Recognizing and understanding perceived barriers to mobility during hospitalization of older patients is an important first step toward developing successful interventions to minimize low mobility. Journal of Hospital Medicine 2007;2:305–313. © 2007 Society of Hospital Medicine.

Improving Processes of Hospital Care During the Last Hours of Life

Abstract: Background: Known for excellence in care in the last days and hours of life, hospice programs can help individuals have a “good death” and lead to higher family satisfaction with quality of care. Our objective was to evaluate the effectiveness of a multicomponent palliativecareinterventionbasedonthebestpracticesofhome hospice and designed to improve the quality of care provided for patients dying in an acute care inpatient setting. Methods:Thisstudywasabefore-afterinterventiontrial conducted between 2001 and 2003. Participants included physician, nursing, and ancillary staff on inpatient services of an urban, tertiary care Veterans Affairs medical center. The palliative care intervention included staff education and support to identify patients whowereactivelydyingandimplementcareplansguided by a comfort care order set template for the last days or hours of life. Data abstracted from computerized medical records of 203 veterans who died during a 6-month periodbefore(n=108)andafter(n=95)interventionwere used to determine the impact of intervention on symptom documentation and 5 process of care indicators. Results: There was a significant increase in the mean (SD) number of symptoms documented from 1.7 (2.1) to 4.4 (2.7) (P.001), and the number of care plans increasedfrom0.4(0.9)to2.7(2.3)(P.001).Opioidmedication availability increased from 57.1% to 83.2% (P.001), and do-not-resuscitate orders increased from 61.9% to 85.1% (P.001). There were nonsignificant changes in the proportion of deaths that occurred in intensive care units (P=.17) and in the use of nasogastric tubes(P=.40),andtherewasasignificantincreaseinthe use of restraints (P.001). Conclusion: Our results indicate that end-of-life care improved after the introduction of the palliative care program.

Expanding the Notion of Researcher Distress: The Cumulative Effects of Coding:

Abstract: Qualitative researchers who explore the individual’s experience of health, illness, death, and dying often experience emotional stress in their work. In this article, we describe the emotional stress we experienced while coding semistructured, after-death interviews conducted with 38 next of kin of deceased veterans. Coding sensitive topic data required an unexpected level of emotional labor, the impact of which has not been addressed in the literature. In writing this discussion article, we stepped back from our roles as interviewers/coders and reflected on how our work affected us individually and as a team, and how a sequence of exposures could exert a cumulative effect for researchers in such a dual role. Through this article, we hope to generate an expanded discourse on how qualitative inquiry impacts the emotional well-being of researchers.

Positive and Negative Religious Coping Styles as Prospective Predictors of Well-Being in African Americans.

Abstract: Research on religious coping has proliferated in recent years, but many key questions remain, including the independent effects of positive and negative religious coping styles on well-being over time. Further, little research on religious coping styles has been conducted with African Americans in spite of their documented importance in this population. The present study examined the independent prospective effects on well-being of positive and negative religious coping styles over the subsequent 2.5 years in a national sample of African American community-dwelling adults. Well-being indicators included depressive symptoms and positive and negative affect as well as self-esteem and meaning in life. Results indicated that when considering positive and negative religious coping styles together, baseline positive religious coping consistently and positively predicted the well-being indicators 2.5 years later, while negative religious coping consistently and negatively predicted the well-being indicators 2.5 years later. These effects remained when examining change in well-being levels over time, although they attenuated in magnitude. Finally, negative religious coping more strongly predicted the negative aspects of well-being (e.g., depressive symptoms, negative affect) 2.5 years later than did positive religious coping, an effect that also remained but was attenuated when controlling for baseline levels of well-being. These results highlight the nuanced relationships between both positive and negative religious coping styles and positive and negative aspects of well-being over time among African Americans. Future research might usefully examine how to minimize negative effects and capitalize on the salutary effects of positive religious coping.

Dying young, dying poor: a sociological examination of existential suffering among low-socioeconomic status patients.

Abstract: Palliating the whole person requires that medicine attend more fully to the phenomenon of existential suffering. The role of social factors, in particular, is often overlooked in attempts to understand why end-of-life suffering does not always respond to physiologic, psychological, and spiritual interventions. Using qualitative data from in-depth interviews with 33 low socioeconomic status (SES) terminally ill patients with cancer, I examine how a sociological framework can provide insights on existential suffering at the end of life. Specifically, I discuss how dying "off time" in the life course, being exposed to the illness trajectories of others, and experiencing social isolation and social death contribute to existential suffering among the terminally ill.

Using Multivariate Statistics

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Bowling alone: The collapse and revival of American community

Abstract: The present historical moment may seem a particularly inopportune time to review Bowling Alone, Robert Putnam's latest exploration of civic decline in America. After all, the outpouring of volunteerism, solidarity, patriotism, and self-sacrifice displayed by Americans in the wake of the September 11 terrorist attacks appears to fly in the face of Putnam's central argument: that \"social capital\" -defined as \"social networks and the norms of reciprocity and trustworthiness that arise from them\" (p. 19)'has declined to dangerously low levels in America over the last three decades. However, Putnam is not fazed in the least by the recent effusion of solidarity. Quite the contrary, he sees in it the potential to \"reverse what has been a 30to 40-year steady decline in most measures of connectedness or community.\"' As an example of how the current \"war on terrorism\" could generate a durable civic renewal, Putnam points to the burst in civic practices that occurred during and after World War II, which he says \"permanently marked\" the generation that lived through it and had a \"terrific effect on American public life over the last half-century.\" 3 If Americans can follow this example and channel their current civic

International Journal for the Psychology of Religion

Abstract: Previous research has established how childhood attachment extends into adult romantic attachment and attachment to God. Other research has shown that individuals' styles of attachment to God are differentially associated with three types of spiritual coping methods, self-directing, deferring, and collaborative. Hernandez, Salerno, & Bottoms (2010) sought to extend this body of research by investigating the relationship between God attachment, spiritual coping, and alcohol use. A "novel link" was established between God attachment and alcohol use (p. 106). Research on spiritual coping methods has identified three spiritual coping styles associated with people's relational state with God: self-directing, a self-reliant coping and problem-solving style that works independently of God; deferring, where the responsibility of problem-solving rests on God alone; and collaborative, a problem-solving style that views God and person as cooperative partners in coping and problem-solving. Moreover, a person's God attachment has been differentially associated with these coping methods. Hernandez, Salerno, & Bottoms (2010) sought to extend research on attachment and coping by being the first to study "the effects of God attachment and spiritual coping on alcohol use" (p. 99). They hypothesized that spiritual coping styles would mediate the effect of God attachment on alcohol use. Specifically, they predicted that insecure God attachment style, compared to secure God attachment style, would use "collaborative and deferring style coping styles less and self-directing coping style more," which would then result in increased alcohol use (p. 100). For the study, 429 undergraduate Introductory Psychology students from the University of Illinois at Chicago participated for course credit. The sample's (60% female) religious orientation was 46% Catholic, 43% Christian, 6% Hindu, 3% Muslim, 2% Jewish, 0.4% Greek Orthodox, and 0.4% Sikh. Five measures were utilized to test their hypotheses. The Attachment to God Scale was used to measure participants' "perceived emotional attachment to God" (p. 101). The Religious Problem-Solving Scale was used to measure participants' "religious problem solving tendencies," broken down into three spiritual coping styles: self-directing, deferring, and collaborative (p. 101). The Alcohol-Related Coping Scale was used to measure participants' "social, coping, and enhancement motives for drinking alcohol" (p. 101). The Alcohol Frequency Scale was used to measure participants' general alcohol use. Finally, participants' religious characteristics, such as religious orientation and level of religious involvement, were measured. To test the data, the researchers first implemented a series of one-way between-subjects ANOVA with God attachment style as the independent variable and spiritual coping styles, alcohol-related coping, and general alcohol use as dependent variables. This was followed by mediation analyses to test if the "effect of God attachment on alcohol use and alcohol coping was mediated by spiritual coping styles" (p. 102). Related to spiritual coping, there was a significant main effect of God attachment on spiritual coping, F(2,226) = 26.88, p