Showing papers in "Western Journal of Nursing Research in 2002"
TL;DR: Results show that children exhibited a more playful mood, were more focused, and were more aware of their social environments when in the presence of a therapy dog, suggesting that animal-assisted therapy (AAT) maybe an appropriate form of therapy.
Abstract: The present study quantitatively evaluated the effects of interaction with dogs on children with pervasive developmental disorders (PDD), disorders characterized by lack of social communications and abilities. While interacting with a therapist, children were exposed to three different conditions: (a) a nonsocial toy (ball), (b) a stuffed dog, and (c) a live dog. Prosocial and nonsocial interactions were evaluated in terms of both behavioral and verbal dimensions. Results show that children exhibited a more playful mood, were more focused, and were more aware of their social environments when in the presence of a therapy dog. These findings indicate that interaction with dogs may have specific benefits for this population and suggest that animal-assisted therapy (AAT) may be an appropriate forrm of therapy
377 citations
TL;DR: Being either a man or a college graduate was associated with lesser feelings of psychological kinship and intimacy, both with pets and people, and neither living with a partner nor having a child affected the strength of pet relationships.
Abstract: This exploratory study investigated how clients of a large urban veterinary center viewed the role of their pet in the famil and how they compared this role to that of humans. In Phase 1, randomly selected clients (N = 201) completed a questionnaire containing scales delineating family relationships and pet attachment. Being either a man or a college graduate was associated with lesser feelings of psychological kinship and intimacy, both with pets and people. Neither living with a partner norhaving a child affected the strength of pet relationships. In Phase 2, 16 participants from Phase I completed a social network instrument and answered questions about family roles and boundaries. Thirteen of the 16 respondents said that there were circumstances in which they would give a scarce drug to their pet in preference to a person outside the family.
288 citations
TL;DR: The authors compare and contrast five approaches for dealing with missing data and suggest that mean substitution was the least effective and that regression with an error term and the EM algorithm produced estimates closest to those of the original variables.
Abstract: Researchers are commonly faced with the problem of missing data. This article presents theoretical and empirical information for the selection and application of approaches for handling missing data on a single variable. An actual data set of 492 cases with no missing values was used to create a simulated yet realistic data set with missing at random (MAR) data. The authors compare and contrast five approaches (listwise deletion, mean substitution, simple regression, regression with an error term, and the expectation maximization [EM] algorithm) for dealing with missing data, and compare the effects of each method on descriptive statistics and correlation coefficients for the imputed data (n = 96) and the entire sample (n = 492) when imputed data are included. All methods had limitations, although our findings suggest that mean substitution was the least effective and that regression with an error term and the EM algorithm produced estimates closest to those of the original variables.
278 citations
TL;DR: Nutritional intake increased significantly when the aquariums were introduced and continued to increase during the 6-week weekly follow-up and participants required less nutritional supplementation, resulting in health care cost savings.
Abstract: This study examined the influence of animal-assisted therapy, specifically fish aquariums, on nutritional intake in individuals with Alzheimer’s disease (AD). Sixty-two individuals with AD who live...
191 citations
TL;DR: Comparison of health-promoting self-care behavior in family caregivers with demographically matched noncaregivers revealed that family caregivers scored significantly lower on all measures of health promotion, with the exception of Nutrition and Number of Medications, and significantly higher on Barriers to Health-Promoting Actions.
Abstract: Caregiving for family members with cognitive impairment is stressful and time consuming. Because of the attention needed to manage the memory and behavior problems of the care receiver, family caregivers have little time to attend to their own health needs. Most research related to the health of family caregivers has been conducted within a stress-illness framework. Fewer researchers have studied caregiver health from a health-promotion paradigm. The purpose of this study was to compare health-promoting self-care behavior infamily caregivers with demographically matched noncaregivers and to investigate the mediational effect of health-promoting self-care behavior on the relationship between stress and well-being. Findings revealed that family caregivers scored significantly lower on all measures of health promotion, with the exception of Nutrition and Number of Medications, and significantly higher on Barriers to Health-Promoting Actions. Health-promoting self-care behavior acted as a mediator to reduce the effect of caregiver stress on general well-being.
156 citations
TL;DR: Health care providers should emphasize overcoming barriers and promote perceived benefits as clinical interventions that may pose the greatest potential to increase physical activity among aging Latina women.
Abstract: Evidence of the benefits of physical activity in the health of aging women continues to grow but questions remain about the factors that influence these women's ability to engage in this behavior. The authors used a qualitative design to describe the social and culture-specific perceived benefits and barriers to physical activity among 143 Latina women, ages 40 to 79. Content analysis of these women's responses revealed that perceived benefits (health promotion, physical fitness, improved roles) and barriers (time constraints of women's roles, personal health, internal and external factors) function as competing elements that may explain physical inactivity. Health care providers should emphasize overcoming barriers and promote perceived benefits as clinical interventions that may pose the greatest potential to increase physical activity among aging Latina women. This emphasis holds promise as a feasible and effective primary care intervention for achieving increased physical-activity-related health benefits.
146 citations
TL;DR: The findings support the long-term therapeutic effects of dogs for persons residing in Alzheimer’s SCUs.
Abstract: Behavioral disturbances are a commonfeature of Alzheimer's disease (AD). Prior studies have demonstrated a significant reduction in agitation behaviors during short-term exposure to a dog on an Alzheimer's special care unit (SCU)for persons with AD. The purpose of this study was to determine the effect over time of a resident dog on problem behaviors of persons with AD in an SCU. A within-participants repeated-measures design was used for this study. The Nursing Home Behavior Problem Scale was used to document behaviors (on days and evenings) I week before and 4 weeks after placement of the dog. Participants on the day shift exhibited significantly fewer problem behaviors across the 4 weeks of the study (F[1, 80] = 7.69, p < .05). No significant change in behaviors occurred on the evening shift. Thefindings support the long-term therapeutic effects of dogs for persons residing in Alheimer's SCUs.
108 citations
TL;DR: It was revealed that families were profoundly affected by the social contexts of mental illnesses and faced confronting the ambiguity of mental illness.
Abstract: Despite decades of research documenting family burden related to mental illness of a relative, little is known about families' responses over time. A grounded theory study was designed to describe families' responses to these severe mental illnesses. Twenty-nine participants representing 17 families were interviewed 3 times over 2 years. Interviews were analyzed using constant comparison. Living with ambiguity of mental illness was the central concern. The basic social process was pursuing normalcy and included confronting the ambiguity of mental illness, seeking to control impact of the illness, and seeing possibilities for the future. Goals were managing crises, containing and controlling symptoms, and crafting a notion of "normal." Strategies were being vigilant, setting limits on patients, invoking logic, dealing with sense of loss, seeing patients' strengths, and taking on roles. The study revealed that families were profoundly affected by the social contexts of mental illnesses.
103 citations
TL;DR: The authors investigated the relationship between care type (acute/chronic), neuroticism, control (primary/secondary), and symptoms of burnout (exhaustion, cynicism, and reduced professional efficacy) amongst 21 chronic care nurses and 83 acute care nurses working in a public hospital in regional Australia.
Abstract: While situational factors such as high workloads have been found to be predictive of burnout, not all people in the same work context develop burnout. This suggests that individual factors are implicated in susceptibility to burnout. We investigated the relationships between care type (acute/chronic), neuroticism, control (primary/secondary), and symptoms of burnout (exhaustion, cynicism, and reduced professional efficacy) amongst 21 chronic care nurses and 83 acute care nurses working in a public hospital in regional Australia. Similar levels of burnout symptomatology and neuroticism were found in each group of nurses, and neuroticism was found to be associated with exhaustion, cynicism, and reduced professional efficacy in the total sample of nurses. Our prediction that primary control would protect against burnout symptoms in acute care nurses was supported only for professional efficacy, and the prediction that secondary control would protect against burnout in chronic care nurses was not supported.
97 citations
TL;DR: A culturally specific explanatory model of diabetes mellitus from the perspective of Mexican Americans living along the United States-Mexican border was developed, and Susto (a fright or scare) was perceived to be the primary cause of diabetes, although participants also incorporated biomedical causes.
Abstract: The purpose of this study was to develop a culturally specific explanatory model (EM) of diabetes mellitus from the perspective of Mexican Americans living along the United States-Mexican bonier Kleinman's concept of EMs of illness was used as the theoretical orientation, and the grounded theory method was used to sample, collect, and analyze data. The Mexican Americans in this study described their perceptions of type 2 diabetes using the following constructs: causes, symptom, treatment, and social significance. Each of the components of Mexican Americans' EM contained elements of both the folk and the biomedical perspective. Susto (a fright or scare) was perceived to be the primary cause of diabetes, although participants also incorporated biomedical causes. Treatment included the use of both herbal and biomedical modalities. The use of herbal remedies was not well understood by the participants despite the fact that some used herbal therapies to control their diabetes.
94 citations
TL;DR: Issues and challenges of ethically acceptable and rigorous research in nursing homes that are related to the dependency and institutionalization of older persons and to setting, staff, and resident characteristics are discussed.
Abstract: Anticipation of increased numbers of older persons throughout the coming decades who will require care and assistance with chronic illnesses and functional deficits has correspondingly increased awareness of the need for nursing research to support best geriatric nursing practices. Although badly needed, research in nursing homes presents challenges. This article discusses issues and challenges of ethically acceptable and rigorous research in nursing homes that are related to the dependency and institutionalization of older persons and to setting, staff, and resident characteristics. Strategies for easing the challenges of nursing research in nursing homes are offered.
TL;DR: Several issues arising with developing and conducting rigorous studies of animal interventions can be identified and discussed and suggestions for avoiding pitfalls are suggested.
Abstract: Animal visitation programs have been used in a wide variety of clinical settings with predominantly positive outcomes reported anecdotally. However, there is also a growing body of research investi...
TL;DR: Social support, self-esteem, and optimism were all positive related to positive health practices, and social support was positively related to self- esteem and optimism.
Abstract: The purpose of this study was to examine the relationships between positive health practices and social support, self-esteem, and optimism. The relationships between social support and self-esteem and between social support and optimism were also examined. Two alternative mediational models. with self-esteem in Model 1 and optimism in Model 2, were tested to help explain the relationship between social support and positive health practices in middle-age adults. The sample of 202 middle-age adults completed a demographic data sheet, the Personal Lifestyle Questionnaire, Personal Resource Questionnaire 85-Part 2, Rosenberg Self-Esteem Scale, and Revised Life Orientation Test. The five correlational hypotheses were supported. Social support, self-esteem, and optimism were all positively related to positive health practices, and social support was positively related to self-esteem and optimism. The two mediational models tested with regression analyses were not supported.
TL;DR: During caregiver singing, a paradoxical effect was observed such that despite an evident reduction in the amount of verbal narration and description by the caregiver, the patient implicitly understood what was happening.
Abstract: Caregiver singing and background music were incorporated into the interaction between caregiver and patient, the aim being to illuminate the meaning of verbal communication between persons with sev...
TL;DR: Understanding the concept of EvBP and joining together to devise best practice for health care organizations can promote achieving the goal of desired patient outcomes.
Abstract: In summarizing this discussion of the meaning of EvBP and best practice and their relationship to each other, there is merit in beginning with a delineation of six characteristics of quality care. These six characteristics synthesized by Brown (2001, p. 1) consist of care that is (a) patient centered, (b) scientifically based, (c) population outcomes based, (d) refined through quality improvement and benchmarking, (e) individualized to each patient, and (f) compatible with system policies and resources. These characteristics set the stage and reinforce critical aspects of the definition of both concepts: EvBP and best practice. For evidence to be meaningfully and successfully translated into practice by individuals, and groups of practitioners, the concept of best practice adds an organizational and ongoing quality monitoring to promote continual improvement. Best practice is not a specific practice per se but rather a level of agreement about research-based knowledge and an integrative process of embedding this knowledge into the organization and delivery of health care. The question "Are EvBP and best practice the same?" has guided this discussion, which has focused on how these concepts are related to each other but not the same. Best practice requires a level of agreement about evidence to be integrated into practice. The challenge now is to answer this question: "How can practice be built based on evidence and an environment supportive of this kind of practice?" The struggle needing to be faced is how to devise strategies to operationalize best practice. A beginning identification of the multiple questions and issues in doing so are outlined by Harrison, Logan, Lynn, and Graham (1998), and Newman and Papadopoulos (2000). Plus, Mulhall (1998) poses the challenging question of how is nursing best placed to maximize the benefits that some kind of evidenced-based care can bring? Research is needed into the situations under which evidence can be adopted into practice--and into the consequences of doing so. Best practice, built on a foundation of EvBP, can bridge the practice-research gap and provide a basis for researchers and clinicians to work together to translate research into meaningful practice. Understanding the concept of EvBP and joining together to devise best practice for health care organizations can promote achieving the goal of desired patient outcomes.
TL;DR: Barriers to the research process were largely congruent with previously identified NH staff characteristics, such as lack of communication between NH staff and the research team, ineffective nursing leadership, decreased staff-to-resident ratios, and high turnover of NH staff.
Abstract: Conducting intervention research in nursing home (NH) settings is particularly challenging because of the advanced age and frailty of the participants and the characteristics of the setting itself....
TL;DR: The present study is an initial effort at describing one ethnic minority group, Latino pet owners, the extent of their relationships with their pet, and the extent to which these relationships maybe beneficial in facilitating health.
Abstract: The majority of the findings regarding pet ownership, interaction, and the human-animal bond have involved only Caucasians or have included other ethnic group members only incidentally. The extent ...
TL;DR: This article is a pedagogical piece on hierarchical cluster analysis, a method for investigating the structure underlying data for finding similar groups of cases in data sets when it is not known a priori how many groups are present.
Abstract: This article is a pedagogical piece on hierarchical cluster analysis, a method for investigating the structure underlying data. Such methods are useful for finding similar groups of cases in data sets when it is not known a priori how many groups are present. The article is laid out as follows: First, a brief history and overview of the methods is presented; second, an illustrative example with a small hypothetical data set is used to clarify fundamental concepts; third, hierarchical cluster analysis is applied to a data set from the author’s own program of research to illustrate one way in which the methods may be employed in nursing research; fourth, the limitations of the methods are discussed; and finally, a list of suggested readings, at varying levels of detail, are provided for the interested researcher.
TL;DR: The results suggest health care providers can better meet the needs of Latino families with children by offering better explanations about children’s diagnoses and treatment plans and demonstrating personalismo, or a friendly, kind, and social approach to care.
Abstract: A focused ethnographic study in an urban Latino community in the western United States describes Mexican-origin mothers’ experiences obtaining and using health services for their children. Repeated...
TL;DR: The need for interventions that focus on development of positive cognitions to better promote resourcefulness in women with type 2 diabetes who are at risk for depression is suggested.
Abstract: The coexistence of diabetes and depression occurs frequently among young and middle-age women. Unless one is resourceful, simultaneous management of the symptoms of both conditions is especially challenging. Skills constituting resourcefulness are learned throughout life and are important for the optimal performance of daily activities. Little is known about specific factors that influence resourcefulness. In this study contextual factors (diabetic and depressive symptoms) and cognitive factors (positive cognitions and acceptance of diabetes) were examined as antecedents of learned resourcefulness in 82 women with type 2 diabetes. Regression analyses showed that depressive symptoms and positive cognitions were significant antecedents of learned resourcefulness: Positive cognitions mediated the effects of depressive symptoms on learned resourcefulness. The findings suggest the need for interventions thatfocus on development of positive cognitions to better promote resourcefulness in women with type 2 diabetes who are at risk for depression.
TL;DR: The findings suggest that culture is an important context circumscribing women’s health/illness experience and marginalization of the women within the context of their patriarchal culture is suggested.
Abstract: The purpose of this study was to explore cultural meanings of breast cancer among Korean women in South Korea. A descriptive longitudinal study using methodological triangulation was conducted, and only qualitative findings are presented in this article. Ten Korean women who were newly diagnosed with a plan of surgery and subsequent chemotherapy, who did have severe fatigue at the time of recruitment, were recruited through Seoul National University Hospital. Data were collected using in-depth, 2-hour interviews and analyzed using thematic analysis. The themes emerged through the analysis process included: (a) “I did wrong,” (b) “I cannot ask male physicians,” (c) “I don’t want to show the operation site to my husband,” and (d) “I do household tasks by myself.” The overriding theme was marginalization of the women within the context of their patriarchal culture. The findings suggest that culture is an important context circumscribing women’s health/illness experience.
TL;DR: It is suggested that nonobligatory visits to nursing home residents from a happy person maybe as beneficial to the resident as visits from a dog.
Abstract: Recent recognition of the importance of the human-animal bond has led to the proliferation of programs designed to improve the lives of nursing home residents through the use of animals. Because hu...
TL;DR: Although further testing is needed, the color chart has potential as a low-cost technology to monitor dehydration and between urine osmolality and serum sodium and the blood urea nitrogen to creatinine ratio.
Abstract: Dehydration is a common water and electrolyte disorder in long-term care residents Practical methods to detect and monitor dehydration are needed This study determined whether urine color measured by a urine color chart reflects hydration status The study employed a repeated measures design with two observations during a 10-hour period Urine color was compared to the criterion standard of urine specific gravity and osmolality The sample included 89 participants from two Veterans’ Affairs facilities Urine color was graded on an eight-level color chart Urine specific gravity and osmolality, serum sodium and osmolality, hematocrit, blood urea nitrogen (BUN), and creatinine were measured using standard laboratory procedures Significant positive associations existed between urine color and both urine specific gravity and urine osmolality and between urine osmolality and serum sodium and the blood urea nitrogen to creatinine ratio Although further testing is needed, the color chart has potential as a l
TL;DR: Results obtained from this study support that this instrument is ready for use in research in which the investigator wishes to measure social support associated with family functioning and the health of families of heart patients.
Abstract: A methodological study was conducted to test the psychometric properties of the Family Functioning, Health, and Social Support (FAFHES) Instrument to be used with families of heart patients. A total of 109 initial items were developed based on knowledge generated by three Finnish academic dissertations concerning family functioning, health, and social support provided by nurses. Data were collected from family members of 161 heart patients. Principal component analysis was performed in each of three total scales: family functioning, family health, and social support. The scales had acceptable reliability (alpha coefficients ranged from .73 to .95). Internal consistency reliability and content validity of the FAFHES have initial support. Results obtained from this study support that this instrument is ready for use in research in which the investigator wishes to measure social support associated with family functioning and the health of families of heart patients.
TL;DR: Sampling design issues inherent in many large national surveys are presented and the rationale for applying sample and variance estimation weights when conducting statistical analyses is explained.
Abstract: Conducting secondary analysis using large national survey data sets to answer pressing research questions is gaining acceptance in the nursing science community There are, however, challenges confronted by researchers who wish to apply secondary analysis to large data sets due to the incorporation of complex sampling designs This article presents sampling design issues inherent in many large national surveys and explains the rationale for applying sample and variance estimation weights when conducting statistical analyses In addition, the rationale for using statistical software packages capable of analyzing data derived from complex sampling designs is described Examples of differences in statistical outcomes with and without weights using Stata and SPSS are provided using data from the Medical Expenditure Panel Survey (MEPS) Based on the example analyses, the implications of the statistical outcome differences for study findings are discussed
TL;DR: Exercise practices and preferences of adult Caucasians, African Americans, and Hispanics with diabetes and to relate that information to diabetes treatment modalities are described.
Abstract: The purposes of this secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) III Household Adult Data File (1988-1994) were to describe and compare exercise practices and preferences of adult Caucasians, African Americans, and Hispanics with diabetes and to relate that information to diabetes treatment modalities. The research questions were: (a) What proportion of ethnically diverse adults with diabetes do and do not exercise? (b) What are the preferred types of exercise by ethnicity, gender, and age? and (c) What are the relationships among exercise participation, exercise preference, and treatment of diabetes by ethnic group? More than one third of the total sample reported no exercise within the last month. There were no significant differences in amount of exercise by ethnic group. Gardening and walking were the preferred forms of exercise across age, gender, ethnicity, and treatment.
TL;DR: From data, a cultural model of social exchange, allowing for cultural diversity, is proposed and can increase the effectiveness of nursing interventions aimed at community-based health promotion.
Abstract: Research shows that social support is essential for healthy psychological functioning. Help seeking and social support are soc ial processes shaped by cultural understandings about how need should be expressed, to whom, and in what circumstances. This study used grounded theory methodology to examine how cultural factors regulate help seeking and social support in a sample of 25 Japanese sojourners' wives living in America. Culturally based social edicts such as mutual responsibility and in-group solidarity were found to promote help seeking and social support. In contrast, culturally specific factors such as enryo (polite deference) hierarchy, and the cultural rules governing reciprocity inhibited these behaviors. From these data, a cultural model of social exchange allowing for cultural diversity, is proposed. This model can increase the effectiveness of nursing interventions aimed at community-based health promotion.
TL;DR: The purpose of this article is to demonstrate the risk to research and clinical assessments caused by a discrepancy in the clinical meaning of scores obtained by total scale scoring and those obtained by individual item scoring.
Abstract: It is possible to have a reliable and valid measure of a clinical phenomenon but to score the measure in a way that inaccurately represents the clinical meaning of the measured phenomenon. The purpose of this article is to demonstrate the risk to research and clinical assessments caused by a discrepancy in the clinical meaning of scores obtained by total scale scoring and those obtained by individual item scoring. The clinical phenomenon that is used in this demonstration is symptom distress as measured by the Symptom Distress Scale (SDS). In this example, the discrepancy in meaning between total scale scores and the individual item scores of the SDS has potential clinical implications as more than 30% of participating adolescent patients at each of four time points spanning a 6-month time period would have been inaccurately assessed when the assessment was based on the total scale score.
TL;DR: The pattern of self-reported mood reflected the participant’s long-standing personality traits of extraversion and neuroticism and demonstrated the need to consider the perspective of the person with dementia when addressing quality-of-life issues in research and practice.
Abstract: Self-reported mood and observations of affect are often used as indicators of emotional well-being. The purpose of this case study was to (a) describe the self-reported mood and affective pattern of an older man with severe cognitive impairments, (b) assess consistency in his responses to mood state, (c) compare mood pattern to premorbid personality, and (d) determine the concordance between self-reported mood and observed affect. Observations of mood and affect were taken three times per day for 35 days. There was concordance between self-reported mood and observed affect. The participant was consistent in his responses to mood 75% of the time. The pattern of self-reported mood reflected the participant's long-standing personality traits of extraversion and neuroticism. Results, although not generalizable, demonstrate the need to consider the perspective of the person with dementia when addressing quality-of-life issues in research and practice.
TL;DR: In this phenomenological study, in-depth interviews were used to obtain a description of spouses’ experiences in heart transplantation and revealed four major, interrelated themes: death-life, vigilance, change, and gift.
Abstract: In this phenomenological study, in-depth interviews were used to obtain a description of spouses’ experiences in heart transplantation. Thematic analysis of the transcripts revealed four major, interrelated themes: death-life, vigilance, change, and gift. The experience was contextualized by the existential grounds of time and other people. Findings suggested that the changes inherent in the transplant experience have not been fully described in previous studies. The theme of death-life was dominant and pervasive in all interviews. As the threat of their husbands’ deaths became less prominent, wives reported difficulty letting go of their vigilance. Although the most outstanding gift was that of the donor organ, spouses also gratefully remembered the donor and donor family. Time was not perceived as a boundary separating periods of the transplant experience; all aspects of time seemed to be woven seamlessly from the past through the present and into the future. Spouses were adamant that health care person...