摘要:

BackgroundThe Minnesota Living With Heart Failure Questionnaire (LHFQ) is a commonly used measure of health-related quality of life in persons with heart failure. Researchers have questioned whether LHFQ is sensitive to subtle differences and sufficiently responsive to clinical interventions because the instrument has demonstrated variable performance in clinical trials.ObjectivesA secondary analysis was conducted to assess the LHFQ for sensitivity to different clinical states and responsiveness to varying intensities of clinical intervention.MethodsA convenience sample of nine experimental or quasi-experimental studies from eight clinical sites in the United States yielded data from 1,136 patients with heart failure. Data in the studies had been collected at enrollment and one, three, and/or six months later. Data were analyzed using descriptive, univariate, and multivariate techniques.ResultsTotal and subscale scores on LHFQ were poorer in those with worse New York Heart Association functional class, although there was no difference in LHFQ scores between classes III and IV. No difference in LHFQ scores was found when patients were classified by ejection fraction. Scores improved significantly following hospital discharge, even in those in the control group. Changes in LHFQ scores were greatest in those receiving high intensity interventions.ConclusionsThe LHFQ is sensitive to major differences in symptom severity but may not be sensitive to subtle differences. It is responsive to high intensity interventions. Investigators are cautioned against using this instrument without first maximizing intervention power or without a control group for comparison.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundDisruptive behaviors are prevalent in nursing home residents with dementia and often have negative consequences for the resident, caregiver, and others in the environment. Behavioral interventions might ameliorate them and have a positive effect on residents’ mood (affect).ObjectivesThis study tested two interventions—an activities of daily living and a psychosocial activity intervention—and a combination of the two to determine their efficacy in reducing disruptive behaviors and improving affect in nursing home residents with dementia.MethodsThe study had three treatment groups (activities of daily living, psychosocial activity, and a combination) and two control groups (placebo and no intervention). Nursing assistants hired specifically for this study enacted the interventions under the direction of a master’s prepared gerontological clinical nurse specialist. Nursing assistants employed at the nursing homes recorded the occurrence of disruptive behaviors. Raters analyzed videotapes filmed during the study to determine the interventions’ influence on affect.ResultsFindings indicated significantly more positive affect but not reduced disruptive behaviors in treatment groups compared to control groups.ConclusionsThe treatments did not specifically address the factors that may have been triggering disruptive behaviors. Interventions much more precisely designed than those employed in this study require development to quell disruptive behaviors. Nontargeted interventions might increase positive affect. Treatments that produce even a brief improvement in affect indicate improved quality of mental health as mandated by federal law.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundSome theorists suggest that boys and girls might experience and express anger in different ways, while others do not, making the study of sex differences in anger an important area for investigation. Further, much has been written theoretically about the health implications of anger, but there is a paucity of studies that have examined the relationship between anger and health variables in early adolescent boys and girls separately.ObjectivesThe objectives of this study were to examine sex differences in anger in early adolescents, and to examine the relationship between anger and several health variables, e.g., current health status, clinical health, eudaimonistic health for boys and girls separately.MethodsThis study compared differences in five anger variables between boys and girls, and examined relationships between the anger variables and health variables for boys and girls separately. The final sample consisted of 148 seventh and eighth graders, ages 12 to 14; 81 were girls and 67 were boys. They responded to the State-Trait Anger Expression Inventory and instruments measuring three health variables.ResultsUsing multisample analysis via LISREL 7 and independentttests, findings indicated that boys and girls did not differ in the experience and expression of anger. Pearson correlations were used to examine the relationships between the anger variables and the health variables for boys and girls separately. Of the 30 relationships examined, 12 were statistically significant; seven of these correlations were for girls, while five were for boys.ConclusionsEarly adolescent boys and girls may not differ in any meaningful way in self-reported experiences and expressions of anger, but they may differ in health outcomes in relation to various types of anger.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundPeople who are HIV-positive now live longer when they have contracted AIDS, and nursing interventions can help improve their quality of life.ObjectivesTo test the effects of an intervention based on developing cognitive coping skills as compared to one focused on facilitating the expression of emotions. Both interventions were intended to help regulate emotional response to an exacerbation of HIV-related symptoms.MethodIn a randomized, controlled trial, 90 hospitalized HIV-positive men were randomly assigned to one of three groups: cognitive, expression, or control. The intervention was administered on three consecutive days in 20–30 minute sessions. Preintervention and postintervention data were gathered on mood, distress, and anxiety.ResultsBoth interventions produced a beneficial effect on negative affect (cognitive groupp= .002, expression groupp= .011), and immediately following the first daily session (p= .001). No change in positive affect was produced by either intervention. Pairedttests indicated a decrease in distress (p= .039), specifically, of intrusive ideation (p= .03), for the cognitive group, which also experienced a decrease in anxiety from immediately before to immediately after each session. Conversely, the expression group experienced an increase in anxiety (p= .018).DiscussionThe cognitive coping skills nursing intervention was effective in helping to regulate HIV-positive persons’ emotional responses to advanced disease. This nursing intervention is feasible for use by skilled practitioners providing daily care.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundTobacco use is the leading cause of preventable death in the United States. Since the first Surgeon General’s Report in 1964 on the health risks of tobacco use, overwhelming evidence regarding increased tobacco-attributable morbidity and mortality has been reported. The purpose of this review was to explore nursing research contributions to this public health issue by evaluating the emergence of publications focused on tobacco in a leading nursing research journal.ObjectivesThe specific aims of this review were to determine, among data-based articles published inNursing Research(1952–2000), how often tobacco use was included (a) in sample descriptions, (b) as a variable potentially associated with study outcomes, and (c) as a finding. Additionally, the frequency of publication of research instruments developed to study tobacco use was evaluated.MethodsData-based articles (n= 1,705) and research briefs (n= 197) were evaluated. Inter-rater reliability (100%) was established by the re-review of 20% of the issues in each decade.ResultsA total of 40 data-based articles (2% of those reviewed) either included tobacco use in the sample description only (n= 11), as an independent or mediating variable (n= 11), or as a finding (n= 18). The majority (53%) of the articles were published since 1990; and 71% of the outcome studies were published within the past 5 years. One study focused on tobacco use among youth, and 1 of 197 instrument articles reviewed focused on tobacco. None of the studies reviewed addressed prevention of tobacco use or strategies to decrease exposure to second-hand smoke.ConclusionsThis review demonstrates that the cessation of tobacco use is emerging as a topic for nursing research, reflecting the increased public health attention on this topic. Increased research efforts are needed in the areas of tobacco cessation and prevention of tobacco use. Researchers should be encouraged to consider tobacco use as a variable potentially affecting outcomes in other research studies.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundMedical conditions and symptoms have been shown to predict level of functioning in older adults, but medical conditions and symptoms have rarely been investigated together in a comprehensive model that included both medical conditions and symptoms as predictors of functioning in older adults.ObjectiveThe purpose of this study was to determine whether the adverse effect of medical conditions on different aspects of functioning in older adults is mediated by the level of symptoms (pain and fatigue). If so, level of functioning may improve if pain or fatigue can be mitigated, even when underlying medical conditions cannot be cured.MethodData from 225 adults aged 65–90 were used to test whether medical conditions, symptoms (pain and fatigue), and six covariates predicted lower body performance, self-reported physical functioning, and self-reported role and social functioning. The fit of a series of models to the data was analyzed using structural equation modeling.ResultsMedical conditions affected self-reported physical functioning and self-reported role and social functioning by increasing the level of symptoms, rather than by direct association. Further descriptive studies are needed to identify other symptoms and modifiable mechanisms by which medical conditions affect functioning. Researchers who investigate the causes of poor functioning in older adults are encouraged to include symptoms in models that hypothesize medical conditions as predictors of functioning outcomes.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundDespite the increasing use of the Internet among nurses, the use of the Internet in nursing research has been rarely discussed and critiqued in terms of issues in protection of human subjects.ApproachIn this article, issues in protection of human subjects in Internet research are explored by analyzing an Internet study to propose directions for human protection in Internet research.ResultsIssues raised through the study include those related to (a) anonymity and confidentiality, (b) security, (c) self-determination and authenticity, (d) full disclosure, and (e) fair treatment.DiscussionBased on discussion of the five issues, development of standardized guidelines, investigator triangulation, and information sharing are proposed as directions for protection of human subjects in Internet research.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundEvent history calendars are used to collect retrospective data about events and life transitions over short and long periods of time. Event history calendars are highly structured, but flexible, approaches to interviewing respondents about past events that use their own past experiences as cues to remembering. Event history calendars incorporate autobiographical memory retrieval mechanisms to assist respondents in reconstructing past events and experiences accurately and completely.ApproachA sample event history calendar and experiences from an ongoing study of adolescent risk behavior are described to illustrate event history calendar methodology application in nursing research. Event history calendar design, recording, interviewing, and interviewer training descriptions are included.DiscussionEvent history calendars have been used extensively for retrospective data collection of occurrence, timing, and sequencing of a variety of life events in population studies, psychology, and sociology research, but not in nursing research. Because event history calendars improve recollection of complex sequences of personal events, they would be ideal for retrospective data collection in quantitative and qualitative nursing studies. Nursing expertise in history-taking make this a natural method of choice for retrospective data collection and as a means of stimulating communication during interviewing.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID