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Background: While longitudinal designs can provide significant advantages compared to single measurement/cross sectional designs, they require careful attention to study infrastructure and the risk of attrition among the sample over multiple time points. Objective: The strategies used to design and manage an appropriate infrastructure for a longitudinal study and approaches to retain samples are explored using examples from 2 studies, a 25-year study of persons living with multiple sclerosis and a 10-year longitudinal follow-up of breast cancer survivors. Results: Key strategies (developing appropriate infrastructure, minimizing costs to participants, and maximizing rewards of study participation) have helped address the serious threat of attrition in these longitudinal samples. Conclusion: Implementation of these strategies can help mitigate some of the disadvantages and leverage the strengths of longitudinal research to produce reliable, insightful, and impactful outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Although cancer experiences and health-related quality of life (HRQOL) differ by sex, little is known about how sex affects comorbid conditions, health behaviors, health service utilization, and HRQOL in young adult (YA) cancer survivors. We sought to determine the relationship of sex to these factors in this population. Methods: This matched case–control, cross-sectional study used data from the Texas Behavioral Risk Factor Surveillance System for 2015–2019. YA survivors aged 18–39 years, were matched to controls. Chi-square and multiple logistic regressions were used to assess the relationship between sex and the measured factors. Results: The analysis included 276 YA survivors and 828 controls. Male survivors were more likely than male controls to have a depressive disorder (OR = 3.06, p = 0.007), smoke (OR = 3.87, p < 0.001), and forgo health care because of cost (OR = 5.60, p < 0.001). Female survivors were more likely than female controls to have at least one comorbidity (OR = 3.52, p < 0.001), forgo health care because of cost (OR = 3.03, p < 0.001), and report poorer HRQOL (aORs = 1.52–2.22, p < 0.05). Female survivors were more likely to have at least one comorbid condition (aOR = 1.70, p = 0.02) than male survivors. Conclusion: YA cancer survivors differed in their health outcomes from both the general population and by sex. Tailored, sex-based interventions are needed to decrease long-term morbidity and improve HROQL in this population. [ABSTRACT FROM AUTHOR]

Background: Because multiple sclerosis (MS) is an autoimmune disease and many individuals with MS take disease-modifying drugs that suppress immune response, serious concerns have been expressed about the potential effect of COVID-19 on those with this chronic condition. Objectives: The purpose of this research was to utilize the most recent 5 years of data from an ongoing longitudinal study of health promotion and quality of life (QoL) among people with long-standing MS to investigate changes across time in functional limitations, health promotion, and health-related QoL. Methods : Participants are mailed an annual survey to complete about their health promotion, depressive symptoms, health status, social support, MS-related functional limitations, and QoL. Differences across time were analyzed with repeated measures of analysis of variances and planned contrasts. Results : In 2021, the 141 participants had a mean age of 69 years and had been diagnosed with MS for 34 years, on average. Most had attended college, were married/partnered women, and reported adequate economic resources. Thirty-seven percent reported they were in poor to fair health. Physical activity and health responsibility scores decreased significantly during 2020-2021 compared with 2017-2019. Significant changes in depressive symptoms, social support, and functional limitation scores followed a different pattern, with the largest changes occurring between 2018 and 2019. QoL and other health promotion scores did not change significantly across time. Discussion : The relatively small changes in health indicators revealed here suggest that older people with long-standing MS may have generally been able to maintain their health promotion, functional abilities, and QoL from before to during the COVID-19 pandemic. However, nurses and other providers should support them to resume their physical activity and regular provider contact as COVID-19 restrictions are eased. The patterns observed here demonstrate the importance of examining changes across an extended period, rather than simply looking at 1 year before and 1 year after a major event, such as COVID-19. These findings can help nurses understand how to help their patients with chronic health conditions maximize their health as they move forward. [ABSTRACT FROM AUTHOR]

BACKGROUND: In addition to heavy workloads, oncology nurses are confronted with emotionally demanding caregiving moments with little training or institutional support for coping and emotional well-being. OBJECTIVES: The aim of this study was to explore the associations and potential predictors among self-compassion, loneliness, anxiety, depression, and professional quality of life in oncology nurses. METHODS: Participants were recruited throughout central Texas. Descriptive statistics, bivariate correlations, and multivariate regression analyses were conducted on survey data. FINDINGS: Burnout and compassion satisfaction were strongly related to loneliness, self-compassion, and depression. Compassion fatigue was most highly related to anxiety and depression. Loneliness made the strongest unique contribution to burnout and compassion satisfaction, and depression was the only statistically significant predictor of compassion fatigue. [ABSTRACT FROM AUTHOR]

Although research about pregnancy for women with disabilities has increased, their postpartum experience has received little attention. Studies generally focus on parenting, not on the health of the mothers themselves, despite recent studies underscoring the health risks they may face. Thus, our purpose was to examine postpartum health among women with physical disabilities, including how they maintain or improve their health. Semistructured interviews were conducted with eleven new mothers with physically disabling conditions. A qualitative descriptive approach was used to analyze the transcribed interviews and identify themes. Nine women had delivered via cesarean section, and most had mobility impairments. Their average age was 35 years; 91% were college educated and 82% had a partner. Six overarching themes were identified: paying a price to have the baby, focus on the baby, supports—or a lack thereof, feelings of isolation, getting challenges under control/overcoming barriers, and not quite there yet/getting back to health promotion. Despite their resilience in dealing with the challenges of caring for their babies within the context of their disabling conditions (including recovery from complications from the birth experience), these women clearly identified the need for additional resources and supports. They also recognized limitations to their own health that came along with their parenting responsibilities. Health care providers should be more attuned to the postpartum needs of women with physical disabilities, and policies should provide additional supports such as insurance coverage for home visits to help maximize women's health and well-being during this important life transition. [ABSTRACT FROM AUTHOR]

Introduction: Adherence to colorectal cancer (CRC) screening recommendations allows for both prevention and early detection of the disease, yet approximately one-third of U.S. adults aged 50-75 years have not regularly received CRC screening. Screening rates are lower for uninsured and rural individuals. We examined the relationships between demographic factors, past CRC screening experience, family history of colon cancer, and preference for CRC screening (fecal immunochemical test [FIT] vs. colonoscopy) and completion of CRC screening in an ethnically diverse, largely rural sample, with a specific focus on uninsured individuals. Methods: Participants were 2,476 uninsured individuals (age, 45-75 years; 66% female) recruited from a community outreach program in northeast Texas. Variables included demographic factors and CRC health-related information. Chisquare tests and hierarchical logistic regression were used. Results: The CRC screening groups consisted of 1,413 who completed screening and 1,063 who did not. After controlling for demographic factors, participants who reported past CRC screening experience (odds ratio [OR] = 1.41, 95% confidence interval [CI] = 1.17, 1.71, p < 0.001) and chose colonoscopy (OR = 1.27, 95% CI = 1.04, 1.55, p = 0.019) had an increased likelihood of CRC screening completion. Conclusion: Educational programs coupled with financial support for screenings may help close the gap in screenings between minority racial/ethnic and gender groups. Participants with previous experience of CRC screening and preference for colonoscopy were associated with completing CRC screening. A focus on individuals' preferences for CRC screening may help develop and target appropriate intervention for promoting CRC screening. Further examination is warranted to determine the associations among various socio-demographic factors, lifestyle and behavioral factors, and psychosocial variables in this disadvantaged population. Moreover, intervention programs should raise awareness of the importance of family history of colon cancer. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Background: Although nursing intervention studies typically focus on testing hypothesized differences between intervention and control groups, moderator variables can reveal for whom or under what circumstances an intervention may be most effective. Objectives: The aim of the study was to explain and illustrate moderator effects using data from a nursing intervention study to improve cognitive abilities in those with a chronic health condition. Methods: The sample consisted of 178 individuals with multiple sclerosis participating in an experimental study of a cognitive intervention. General linear models were used for analyses. Interaction terms were created to represent moderator effects on three outcomes: self-reported cognitive abilities, use of memory strategies, and verbal memory performance. Results: The Charlson comorbidity index significantly moderated the intervention effect on self-perceived cognitive abilities. Years of education significantly moderated the intervention effect on use of memory strategies. Scores on a general self-efficacy measure significantly moderated the intervention effect on the Controlled Verbal Learning Test–Second Edition. Discussion: These analyses highlight the key role that moderator effects can play in nursing research. Although random assignment to groups can control potentially biasing effects of extraneous differences among individuals in intervention and control groups, those very differences may suggest fruitful avenues for hypothesis generating research about what works best for whom in intervention studies. [ABSTRACT FROM AUTHOR]

Aims: To synthesize evidence about the effectiveness of expressive arts interventions used to reduce psychosocial stress among healthcare workers. Design: Quantitative systematic review following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Data Sources: SocINDEX, PsycINFO, Pubmed, CINAHL. Review Methods: Databases were searched from 1997–2017. Fourteen studies met the criteria for final selection. Results: Most studies occurred in the US (N = 11). Of the 897 participants, 59% were nurses. Two studies were randomized controlled trials and the others were a variation of a 1‐group or 2‐group pre‐ or quasi‐experimental study. The intervention characteristics included 50% art‐based, 29% music‐based, and 21% used storytelling or narrative. The length of intervention varied from 1 hr to 13 weeks; 5 lasted 6 weeks. Improved outcomes were found in 13 of 14 studies reviewed and the greatest improvements were seen in burnout, stress, and emotional outcomes. Overall, music and art‐based interventions had greater impact on well‐being than storytelling or narrative. Conclusions: This systematic review provides preliminary evidence for the effectiveness of expressive arts interventions. Impact: Care for others is a preeminent value in health care; however, this can come at the expense of caring for oneself. Psychosocial stress poses a significant threat to the well‐being of the healthcare workforce. Expressive arts interventions provide a creative means for reducing caregiver stress to remain well and able to provide high quality care to patients. The use of arts for healing has global application because expressive arts intervention can be culturally tailored and relevant. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine changes in new nurses' competencies across the 1st year of practice. BACKGROUND: Competency assessment is a challenge for nurse residency programs and often focuses on skills checklists and confidence self-reports. The Appraisal of Nursing Practice, an observational rating based on Quality and Safety in Nursing Education standards, was developed to help evaluate an RN residency program. METHODS: Preceptors, nurse educators, and/or unit managers from various units rated new nurse residents. Ratings were compared for 353 nurses at 3 points: within the 1st month in the program (T1), at 5 months (T2), and at month 11 (T3). RESULTS: Competency ratings increased significantly for all subscales from T1 to T2. Ratings continued to increase significantly from T2 to T3, although at a slightly slower rate. Teamwork and evidence-based practice increased the most. CONCLUSIONS: Future studies should explore factors affecting the trajectory in developing nursing competencies within various settings. [ABSTRACT FROM AUTHOR]

Although many cognitive performance tests and self-reported cognitive concerns scales have been used to evaluate cognitive functioning, fewer measures assess the use of compensatory cognitive strategies for daily activities among those experiencing mild levels of cognitive impairment. The Compensatory Cognitive Strategies Scale was developed to measure frequency of self-reported cognitive strategies to decrease distractions, organise and sequence activities, and to utilise newly available computer aids to assist memory among those with multiple sclerosis (MS). Cronbach's alpha, a measure of internal consistency reliability, was .89 and .90 in two different samples. Concurrent validity was supported by the total score's moderate correlation with the MMQ-Strategy Scale (rs = .67) and by a statistically significant increase in total scores for those who had participated in an intervention designed to improve their cognitive abilities. Correlations were stronger with another strategy measure than with measures of other constructs such as health-promoting behaviours, thus supporting the scales convergent versus divergent validity. These initial findings suggest that the Compensatory Cognitive Strategies Scale may be useful to both researchers and clinicians working to build compensatory strategies for day-to-day functioning among those with mild cognitive impairment. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We describe the development of the Appraisal of Nursing Practice (ANP) and present initial psychometric data. BACKGROUND: Although measures of new nurses' confidence in clinical practice exist, psychometrically sound observational tools that assess a broad range of nursing competencies are needed. METHODS: Based on the Quality and Safety Education for Nurses competencies, the 37-item ANP covers person-centered care, teamwork and collaboration, evidence-based practice/quality improvement, safety, informatics, professionalism, and overall satisfaction (with the new nurse's functioning). Cognitive interviewing was used to refine the items. Assessment of interrater reliability and a field test in a new nurse residency program were conducted. RESULTS: Interrater reliability and internal consistency reliability were generally acceptable. Scores increased significantly for nurses as they moved through a nurse residency program. CONCLUSIONS: The ANP can help nursing administrators identify areas where nurse residents are building needed competencies versus areas that need more work to achieve desired competency outcomes. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To test combining a group intervention to build self-efficacy for using compensatory strategies and lifestyle adjustments with brain-training practice to improve cognition. Design: A quasiexperimental design. Setting: Texas Oncology, a community oncology practice in Austin. Sample: 20 women aged 35-65 years, who had finished chemotherapy at least three months before the study, were within five years of completing all treatment, and had selfreported cognitive concerns. Methods: Six group sessions to build self-efficacy for using compensatory strategies, along with other health behaviors that affect cognitive performance, were combined with practice on a computer-based training program. Female breast cancer survivors were recruited through flyers, mailings, and personal contacts. Main Research Variables: Cognitive performance, cognitive concerns, cognitive/memory strategies, fatigue, emotional distress, sleep disorders, and quality of life. Findings: Participants reported that the intervention was useful in building cognitive abilities. Although scores on performance tests did not increase, ratings of cognitive concerns, fatigue, emotional distress, and sleep disturbance decreased significantly. Use of cognitive/ memory strategies increased significantly. Conclusions: This pilot study demonstrated the feasibility of combining a group intervention with brain-training practice. A larger randomized trial would afford a more rigorous test of efficacy. Implications for Nursing: A growing body of evidence regarding potential interventions to address survivors' cognitive problems exists. Nurses should counsel breast cancer survivors about fatigue, sleep deprivation, and emotional distress, as well as the effects of cancer treatment on cognition. [ABSTRACT FROM AUTHOR]

AIM The aim of this study was to assess learning outcomes from a simulation on providing care to a critically ill patient from whom care is ultimately withdrawn. BACKGROUND Nursing students have anxiety and low perceived competence for caring for dying patients. Effective strategies for teaching communication, assessment, and basic nursing skills are needed. METHOD A pretest-posttest design compared perceived competence and attitudes in caring for dying patients with three separate cohorts of undergraduate nursing students performing the simulation. RESULTS The cohorts had significantly improved scores on the perceived competence (p < .001) and attitude (p < .01) measures following the simulation. Reliability for a new instrument to assess perceived competence in caring for dying patients was also established. CONCLUSION This study's simulation offers a robust teaching strategy for improving nursing students' attitudes and perceived competence in caring for dying patients. [ABSTRACT FROM AUTHOR]

Background: Many survivors report troubling cognitive problems that can persist long after active treatment and seriously affect their quality of life, particularly in terms of employment. Objectives: The purpose of this study was to explore survivors' perceptions of their cognitive functioning. Methods: Ten female breast cancer survivors receiving treatment in a community oncology setting participated in interviews or a focus group. Findings: Six major themes were derived from the analysis: cognitive problems, effects on employment, emotional response, search for answers, coping mechanisms, and the providers' role. The breast cancer survivors reported psychological distress about perceived cognitive problems in concentration, memory, and other cognitive functions. They sought answers about the cause and were frustrated by a lack of information from providers. Although treatment strategies are limited, healthcare providers should validate patients' concerns by discussing possible cognitive limitations and should allow them to talk about the impact of cognitive problems on their lives. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To explore the experience of living with a preexisting functional disability and a cancer diagnosis and to identify strategies that promote health in the growing population of cancer survivors.Research Approach: Qualitative, descriptive.Setting: Four sites in the United States.Participants: 19 female cancer survivors with preexisting disabling conditions.Methodologic Approach: Four focus groups were conducted. The group discussions were audio recorded and transcribed and analyzed using content analysis techniques.Findings: Analytic categories included living with a cancer diagnosis, health-promotion strategies, and wellness program development for survivors with preexisting functional limitations. Participants described many challenges associated with managing a cancer diagnosis on top of living with a chronic disabling functional limitation. They identified strategies to maintain health and topics in health-promotion programs tailored for this unique group of cancer survivors.Conclusions: The "double whammy" of a cancer diagnosis for people with preexisting functional limitations requires modification of health-promotion strategies and programs to promote wellness in this group of cancer survivors.Interpretation: Nurses and other healthcare providers must attend to patients' preexisting conditions as well as the challenges of the physical, emotional, social, and economic sequelae of a cancer diagnosis.Knowledge Translation: Cancer survivors with preexisting functional disabilities had difficulties finding cancer care providers who could manage their unique needs. That may be because some cancer-care providers are inadequately prepared to care for patients with cancer who have complex preexisting conditions. Cancer survivors with preexisting conditions may benefit from health-promotion programs that emphasize self-advocacy strategies, management of the economic impact of multiple diagnoses, and wellness activities adapted to their unique functional limitations. [ABSTRACT FROM AUTHOR]

The article discusses a randomized controlled single-blinded trial testing a computer-assisted cognitive rehabilitation intervention, MAPSS-MS (Memory, Attention, and Problem Solving Skills for persons with Multiple Sclerosis), to help individuals acquire the highest level of cognitive functioning and functional independence. The results showed that MAPSS-MS group had greater improvements than the control group on four of the seven neuropsychological tests involved.

Purpose/Objectives: To explore whether measures of resources, barriers, and health-promoting behaviors would add significantly to the prediction of health-related quality of life among survivors with disabilities that occurred prior to their cancer diagnosis once contextual factors were controlled for.Design: A descriptive correlational study.Setting: Adult cancer survivors with preexisting disabling conditions who had completed active treatment were recruited from throughout the United States.Sample: Most of the 145 respondents were breast cancer survivors with preexisting neuromuscular conditions such as polio and multiple sclerosis. The average time since cancer diagnosis was nine years.Methods: Respondents completed a mailed survey.Main Research Variables: Health-promoting behaviors, self-efficacy, barriers to health promotion, social support, functional limitations, cancer-related variables, depression, and quality of life.Findings: The sample reported poorer physical well-being than other cancer survivors without preexisting disabling conditions. Health-promoting behaviors and psychosocial factors, such as depressive symptoms and self-efficacy, added significantly to the prediction of physical, social, emotional, and functional components of health-related quality of life after contextual factors entered the equations.Conclusions: The findings underscore the importance of providing this population with the means to promote their health to the greatest extent possible, given the multiple threats to their health status.Implications for Nursing: Nurses may be able to help survivors with preexisting disabling conditions reduce the negative influence of poorer health status and functional limitations on quality of life by providing interventions that reduce depression and build perceived ability to engage in health-promoting behaviors. [ABSTRACT FROM AUTHOR]

Purpose: Cognitive training improves mental abilities in older adults, but the benefit to minority elders is unclear. We conducted a subgroup analysis of subjects in the SeniorWISE (Wisdom Is Simply Exploration) trial to examine this issue. Design and Methods: SeniorWISE was a Phase 3 randomized trial that enrolled 265 nondemented community-dwelling older adults aged 65 years and older between 2001 and 2006. Participants were randomly assigned to 12 hr of either memory or health training. Results: The sample was 79% female, 71% Caucasian, 17% Hispanic, and 12% African American. On the Rivermead Behavioural Memory Test (RBMT), 28% of the sample scored normal, 47% scored poor, and 25% impaired. Memory performance changed differently over time depending on the demographic characteristics of participants. Both Hispanics and Blacks performed better than Whites on visual memory, and Blacks performed better over time on instrumental activities of daily living. On all performance measures, lower pretest scores were associated with relatively greater improvements over time. Implications: Our analyses suggested that minority participants received differential benefits from the memory training; however, this remains speculative because the 3 ethnic groups in the sample were not equivalent in size. The question of why Black and Hispanic participants often made greater improvements needs further exploration. [ABSTRACT FROM PUBLISHER]

Purpose: The original version of the Direct Assessment of Functional Status (DAFS), a measure of instrumental activities of daily living (IADLs), was found to have a ceiling effect in older adults living independently in the community. This suggested that the tasks measured, although relevant, do not require full use of this population’s abilities, and thus, the instrument may not be sensitive to the early decrements in IADLs that can signal initial cognitive impairment and may not detect improvements in IADLs over time, which is especially important in intervention research. Design and Methods: By removing items with little to no variation and adding more difficult subscales that emphasized medication management skills, we designed the DAFS-Extended (Direct Assessment of Functional Status-Revised [DAFS-R]) to be more challenging for elders living independently. Results: Analysis with a sample of 45 older adults suggested that scores on the DAFS-R appear to be more normally distributed than on the original version. The DAFS was able to differentiate individuals with varying standard profile scores on the Rivermead Behavioural Memory Test memory performance instrument (normal, poor, and impaired). In addition, the reliability and validity of the DAFS-R were supported in this sample. Implications: Given the large number of older adults who regularly take multiple prescription medications, deficits in medication management skills can have serious consequences. A performance measure that emphasizes these higher level daily living skills can help providers screen for initial signs of functional decline. [ABSTRACT FROM PUBLISHER]

Deciding about hormone therapy (HT) use is particularly complex for women with mobility impairments. While HT controls menopausal symptoms, the potential increased risk of blood clots resulting from physical inactivity can contraindicate HT use. These women, therefore, may benefit from interventions to help them tailor standard information about HT. We randomly assigned women to receive either a tailored decision support intervention or standard menopausal information. Both groups (n = 176) significantly decreased their decisional conflict and uncertainty and increased knowledge after receiving the treatment materials. We interpret the findings in the context of limited medical information about HT for women with disabilities. [ABSTRACT FROM AUTHOR]

Objective: Cancer-related cognitive impairment is common following the end of adjuvant treatment and there are limited treatment options for it. We compared the sustained cognitive (primary) and psychological (secondary) effects of mantra meditation to classical music listening 8 weeks after interventions ended (Time 3) compared to baseline (Time 1).Methods: A two-group parallel random assignment experimental design was used in a community setting. Thirty one breast cancer survivors (ages 21 to 75, received chemotherapy, and reported cognitive complaints) were randomly assigned to practice mantra meditation (n = 16) or listen to classical music (n = 15) 12 min a day for 8 weeks. No blinding was used. Repeated measures analysis of variance models were used to compare Time 1 and Time 3 data for the 26 survivors (13 per group) who completed the interventions and Time 3 data collection.Results: Verbal fluency (p < .001, ηp2 = 0.58), attention (p = .002, ηp2 = 0.33), immediate memory recall (p < .001, ηp2 = 0.38), perceived cognitive impairment (p < .001, ηp2 = 0.39), and quality of life (p = .001, ηp2 = 0.35) improved significantly across time for both groups. The two conditions did not differ significantly in changes across time. There were no adverse effects.Conclusion: Daily mantra meditation or classical music listening may be beneficial for cognitive outcomes and quality of life of breast cancer survivors with cancer-related cognitive impairment. The cognitive benefits appear to be sustained beyond the initial intervention period. Clinical Trials Registration number: NCT03696056, recruitment status completed. The study details can be accessed at: https://clinicaltrials.gov/ct2/show/NCT03696056 KEY MESSAGE: There are limited treatment options for managing cancer-related cognitive impairments. Daily mantra meditation or classical music listening for 12 min a day may improve cognitive outcomes and quality of life for cancer survivors, with no negative side effects. [ABSTRACT FROM AUTHOR]

Past research has suggested smoking disparities among individuals with disabling conditions. We contrasted smoking behaviors of those with and without disabilities from 2001 to 2005. Design: Descriptive correlational study. Sample: Telephone interviews were conducted in all states with noninstitutionalized adults. Half were female; most were Anglo (70.5%) and had at least a high school education (90%). Their average age was 45 years. Approximately 19% of the sample reported being disabled. Measurement: We analyzed 4 years of data from the population-based Behavioral Risk Factor Surveillance System. Results: While individuals with disabilities were more likely to report ever having smoked than nondisabled respondents, current smoking behaviors were more similar in the 2 groups, and the difference was not statistically significant when demographic factors were included in the model. Smoking behavior decreased somewhat for nondisabled persons between 2001 and 2005, but remained fairly constant for those with disabilities. However, those with disabilities were more likely than those without disabilities to have attempted to quit smoking in all years. Conclusions: Findings underscore the importance of smoking cessation programs tailored to people with disabilities. The role of the public health nurse in addressing smoking cessation at the individual, system, and community level is discussed. [ABSTRACT FROM AUTHOR]

Acceptance of chronic conditions often has been studied from the perspective of grief and loss. This paper presents a new conceptualization of acceptance of chronic conditions that is grounded in the perspective of those living with a chronic condition and focuses on adaptation to and acceptance of change in one's life. Data obtained from a sample of 822 persons with multiple sclerosis and a sample of more than 2,000 polio survivors support the reliability and validity of the new Acceptance of Chronic Health Conditions Scale. [ABSTRACT FROM AUTHOR]

Focuses on menopause healthcare for physically disabled women. Menopausal symptoms; Impacts that the menopause transition may have on women with disabilities; Information on the "Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women," published by the American Heart Association.

We investigated the question, how do older men who drink alcohol differ from those who do not drink on measures of cognitive function, memory, affect, and health? Of the nonprobability sample of male participants ( N = 60 ), 35 (58%) of the males reported some degree of alcohol consumption. Eleven men had one or more drinks per day, 14 had one or more drinks per week, and 9 were occasional drinkers. The drinkers reported significantly less depression, had higher self-reported general health and vitality, and had higher cognitive performance, cognitive flexibility, and verbal memory, and greater knowledge of memory processes. [ABSTRACT FROM AUTHOR]

The purpose of the study was to examine the factors associated with hormone therapy (HT) use among women with mobility impairments. A non-probability sample of 188 menopausal women (average age = 53 years) from 38 states was recruited in 2004 for the study. Twenty-two percent of participants were currently taking HT; 33% were past users. Using multinomial logistic regression, this study found that those most likely to be taking HT now or in the past were older women, knowledgeable about HT, had had a hysterectomy, had bone loss, and had their provider's encouragement. Implications for health care providers are discussed. [ABSTRACT FROM AUTHOR]

The article focuses on challenges of surveying people with disabilities in surveys which includes these people in design and implementation of the research. Project Asking Consumers to Indicate Their Own Needs and Strengths was designed to enable researchers to gather information about the perceptions of people with a wide range of disabling conditions about their life. Author suggests that researchers should focus on identifying direct service staff who understand and value the research and can interpret the purpose of the study for people with disabilities, their families, and other staff members.

The Expect Respect Project, a violence prevention program, was developed to reduce the incidence of bullying and sexual harassment by creating a positive school climate in which inappropriate behaviors are not tolerated and staff members respond consistently to incidents. The project implemented an educational intervention for students', parents, and staff members on expecting respect in student relationships and strategies for responding to inappropriate student behaviors. This article describes the educational intervention and evaluation of the project. Findings from the project showed a significant increase in awareness of bullying following the educational intervention. Bullying was reported to have occurred in areas with less adult supervision such as the playground, cafeteria, hallway, and buses. Students thought staff would respond to inappropriate behaviors by telling students to ignore verbal bullying or sexual harassment. In contrast, staff at the elementary schools thought adults would respond to inappropriate behaviors by telling the bully to stop, calling his or her parents, or giving a specific punishment. [ABSTRACT FROM AUTHOR]

Proposes improvements in the use of experimental and control groups in clinical nursing studies. Protection against false causal inferences that could be made when both the treatment and control groups change; Impact of factors such as testing effects, reactivity, contamination, maturation, history and other measurement effects; Factors that affect a nursing study's ability to demonstrate and experimental effect.

This study describes the menopausal experiences of women with physical disabilities and their knowledge and use of hormone replacement therapy (HRT). 166 women completed a mailed survey of demographic and disability characteristics, health history, menopausal information, and HRT knowledge. The typical respondent was a 52-year-old, Anglo, college-educated woman with a neuromuscular disorder. Half of the menopausal women were taking HRT, and 47% had a hysterectomy. HRT use was significantly associated with hysterectomy status, amount of HRT information received from providers, and regular gynecologic examinations. Effective interventions are needed to assist these women in making key health decisions during menopause. [Copyright &y& Elsevier]

Whereas making decisions during menopause can be challenging for all women, those with physical impairments face special issues with respect to menopause in general and hormone replacement therapy (HRT) in particular. In this correlational study, the authors explored the factors such women consider when making decisions about HRT One hundred sixty-seven women with physical impairments throughout the United States completed surveys concerning their attitudes and knowledge about HRT. Approximately half the menopausal women were currently taking HRT. The strongest predictor of HRT use was women's perceptions of their health care providers' opinions about their taking HRT, combined with their motivation to comply with the provider's recommendation. This finding points to the significant role that nurses and other health care providers play in assisting women to make informed health care choices during menopause. [ABSTRACT FROM AUTHOR]

Analyzes the interviews of staff members from community centers providing services to people with mental retardation about the implementation of an approach to service delivery that utilized Essential Lifestyle Planning. Importance of organizational factors in the program; Role of findings in providing directions for future training and technical assistance activities.

Finding cost-effective ways to increase response to mailed surveys is a concern for many nurse researchers. This study compared two follow-up methods: sending a second questionnaire packet versus sending a reminder postcard to those who did not respond to an initial mailing. Although the second questionnaire yielded a higher response than did the postcard, the cost per additional response was approximately 2 1/2 times higher for the questionnaire than for the postcard when the differential cost of the two mailings is considered. [ABSTRACT FROM AUTHOR]

Presents information on a study which evaluated a school-based bicycle helmet program for preventing pediatric head injuries. Effectiveness of the program; Factors that influence the intervention; Role of pediatric nurses in the intervention; Importance of parental participation in problem-solving.

Explores the perceptions of self-efficacy and health attitudes among people with cerebral palsy living in the community. Methodology followed in the study; Sample selected; Instruments utilized; Results and its implications for rehabilitation professional.

Self-regulation (SR) has been defined as consisting of three basic strategies: selection, optimization, and compensation. This study investigates these three SR strategies as predictors of arthritis self-efficacy, quality of life (QOL), and health-care utilization in community-dwelling people aging with arthritis and comorbidities. One hundred forty individuals over age 50 years provided demographic characteristics and completed surveys on comorbidities, health resources, use of SR strategies, symptoms, arthritis self-efficacy, QOL, and health-care utilization. Multivariate hierarchical stepwise regressions were used to examine SR strategies as predictors for arthritis self-efficacy, and together with arthritis self-efficacy as predictors for health-care utilization, and QOL. Physical symptoms; SR strategies, especially optimization; and income adequacy significantly predicted arthritis self-efficacy. Arthritis self-efficacy and mental and physical symptoms significantly predicted QOL. This study adds evidence to support the role of SR strategies, especially optimization, in building arthritis self-efficacy for better self-management and QOL in persons with arthritis and multiple chronic conditions. [ABSTRACT FROM AUTHOR]

More than 6 million people in the US are considered at high-risk for memory impairments and mild cognitive impairment (MCI), both because they are cancer survivors and because they are over 55 years of age. The purpose of the intervention is to provide participants with the confidence, knowledge, skills, and support necessary to improve their memory performance and consequently their everyday functioning. Self-Efficacy theory Participants were enrolled in the study for 26 months and tested on five occasions for 2 years post-intervention. The study aimed to improve everyday memory (RBMT), verbal memory (Hopkins Verbal Learning), and visuospatial (Benton Visual Memory Test) memory performance, memory self-efficacy (MSEQ), state and trait anxiety with the Spielberger State-Trait Anxiety Inventory (STAI), depression (Center Epidemiological Studies-D), and performance-based functional ability, specifically the instrumental activities of daily living (IADLs) measured with the Direct Assessment of Functional Status (DAFS). Internal consistency reliabilities were computed for all measures used in the analyses reported here; all were above .75 Moderate to large effects were associated with changes in SPS and HVLT memory performance scores, in memory self-efficacy and the Complaints and Strategies Subscales of the metamemory self-report. There were also moderate effects for group by time interactions on the BVMT memory performance measure, the memory self-efficacy measure, the CESD, the trait anxiety measure, and the Complaints subscales of the metamemory measure. On many of these measures there was a tendency for the intervention group to improve more than the comparison group, although the trend was not always consistent across time. Although the number of cancer survivors in this analysis was small, the results do suggest that cancer survivors can benefit from both interventions and the memory intervention seems to have specific impacts on self- reported memory measures. Funding Sources: National Institutes on Aging (R01 AG 15284), 2001-2006. [ABSTRACT FROM AUTHOR]

The well-being of mothers and infants is influenced by mothers’ behavioral and psychosocial health (B&PH), yet it is often neglected during healthcare visits. To address this gap, this study aimed to develop and evaluate acceptability of a postpartum toolkit (screening questionnaire, feedback template, and decision aid) to promote B&PH. Using a decision-making model and participatory design (N = 24), a B&PH screening questionnaire was refined, and prototypes of feedback templates and decision aids for selecting health goals were developed. Most mothers in this multi-ethnic sample rated the resulting toolkit as easy to understand/use and useful, and reported they were likely to act on their health goals. Toolkit ease of use and usefulness ratings were largely unrelated to education, ethnicity, and acculturation. In conclusion, findings support the toolkit’s acceptability and applicability to women of diverse backgrounds. The toolkit is a promising strategy to engage mothers in setting goals to promote B&PH. [ABSTRACT FROM AUTHOR]

Background: A gap in research about the trajectories of function among men and women aging with functional limitations because of multiple sclerosis (MS) hinders ability to plan for future needs. Objectives: Using a biopsychosocial model, we characterize how men and women with MS report changes over time in their function and test how person-level differences in age, diagnosis duration, and sex influence perceived function. Methods: A longitudinal study with multiple waves of surveys was used to collect data on participant perceptions of function, as well as demographic and contextual variables. Self-reported functional limitation was measured over a decade. The study participants were community residing with physician-diagnosed MS. Results: The people with MS had a diagnosis duration of about 13 years and were around 51 years of age, on average, at the start of the study. They were primarily women and non-Hispanic White. We analyzed the data using mixed-effects models. Subject-specific, functional limitation trajectories were described best with a quadratic growth model. Relative to men, women reported lower functional limitation and greater between-person variation and rates of acceleration in functional limitation scores. Discussion: Results suggest function progressed through two pathways for over a decade, particularly closer to diagnoses. Variability in trajectories between individuals based on sex and years since diagnosis of disease indicates that men and women with MS may experience perceptions of their function with age differently. This has implications for clinician advice to men and women with MS. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To explore whether measures of resources, barriers, and health-promoting behaviors would add significantly to the prediction of health-related quality of life among survivors with disabilities that occurred prior to their cancer diagnosis once contextual factors were controlled for.Design: A descriptive correlational study.Setting: Adult cancer survivors with preexisting disabling conditions who had completed active treatment were recruited from throughout the United States.Sample: Most of the 145 respondents were breast cancer survivors with preexisting neuromuscular conditions such as polio and multiple sclerosis. The average time since cancer diagnosis was nine years.Methods: Respondents completed a mailed survey.Main Research Variables: Health-promoting behaviors, self-efficacy, barriers to health promotion, social support, functional limitations, cancer-related variables, depression, and quality of life.Findings: The sample reported poorer physical well-being than other cancer survivors without preexisting disabling conditions. Health-promoting behaviors and psychosocial factors, such as depressive symptoms and self-efficacy, added significantly to the prediction of physical, social, emotional, and functional components of health-related quality of life after contextual factors entered the equations.Conclusions: The findings underscore the importance of providing this population with the means to promote their health to the greatest extent possible, given the multiple threats to their health status.Implications for Nursing: Nurses may be able to help survivors with preexisting disabling conditions reduce the negative influence of poorer health status and functional limitations on quality of life by providing interventions that reduce depression and build perceived ability to engage in health-promoting behaviors. [ABSTRACT FROM AUTHOR]

The article reports a study to determine if an association existed among health literacy, memory performance, and performance-based functional ability in community-residing older adults. Health literacy scores were evaluated using the Rapid Estimate of Adult Literacy in Medicine (REALM) method. It was concluded that while both treatment and control conditions improved on cognitive outcomes, a need exists for development of a broader assortment of health literacy instruments.

The purpose of this study is to compare Mexican American adolescent mothers with and without childhood sexual abuse (CSA) histories to examine the influence of CSA on dissociation, selection of infant feeding method, and intimate parenting anxiety. Participants are 78 English-speaking adolescents between 15 and 19 years of age and recruited from the southwestern United States. Nearly one third of the sample (n = 24, 30.77%) reports CSA histories. There is no correlation between CSA history and intimate parenting anxiety, no difference between breast-feeding and formula-feeding mothers in CSA severity, and intimate parenting anxiety does not predict dissociation. These findings are inconsistent with previous research. Supportive resources may explain the inconsistency and play a role in adolescent mothers' responses to CSA. Further research is necessary to explore these possibilities. [ABSTRACT FROM AUTHOR]

This paper describes strategies developed to recruit and retain an ethnically diverse sample in a longitudinal intervention of 246 participants in the SeniorWISE study. The ethnic and socioeconomic differences of these participants necessitated the use of different methods of effectively communicating with this population. Recruitment benefited from the use of focus groups, media attention, and personal appearances in the community. Educational strategies included modification of language and examples. Testing sessions were called interviews, and team members were available to answer questions and to read the instruments to participants, when desired. Participants were sent birthday cards and a monthly newsletter. The study is 90% completed. [ABSTRACT FROM AUTHOR]

Objective In this paper we investigated the question, how do older women who drink moderate amounts of alcohol differ from those who do not drink on measurements of cognitive function, memory, affect and health? Methods The nonprobability sample of female participants (n = 182) averaged 75 years of age and had a Mini Mental State Examination scores of 28. The participants were asked to indicate whether they drank alcohol or abstained (yes/no) and if they indicated that they did drink, to describe how many drinks they consumed in a given period of time (day/week/month). Results None of the participants acknowledged drinking more than 2 drinks a day. Caucasian women had the largest number of moderate drinkers (53% vs 47%), while the majority of African–American and Hispanic women reported not drinking. The moderate drinkers reported less depression, had higher self-reported health, performed better on instrumental everyday tasks, had stronger memory self-efficacy, and used more strategies to improve memory performance. In addition, these women had higher performance on tests of executive function: attention, concentration, psychomotor skills, verbal-associative capacities, and oral fluency. Conclusions The circumstances under which people drink are complex and were not evaluated in this study. Therefore, rather than endorsing drinking behavior, these findings suggest that future research might examine why elders make the decision to drink, the circumstances that predispose women to drink (alone/with others), and other qualities that characterize female drinkers over the age of 65. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Presents information on the study which deals with the use of NUD.IST 3.0 software in managing the qualitative data of dyspnea stimuli. Advantages and disadvantages of the software; Conclusions.

Part I. Describes the features of the computer software, Non-numerical Unstructured Data Indexing, Searching and Theorizing (NUD.IST), and how it was used in a qualitative study of dyspnea stimuli. Description of NUD.IST; Procedures used in the qualitative data analysis.

Background: Women with disabilities, a health disparities group, are choosing to become parents, but it is unclear the extent to which they face related disparities regarding key health promotion behaviors associated with perinatal outcomes. Men's health behaviors may also directly or indirectly influence these outcomes. The purpose of this study was to compare the preconception health behaviors of reproductiveage women and men with mobility-related disabilities to their non-disabled counterparts to better understand areas for improving health promotion in this population. Methods: We used Texas Behavioral Risk Factor Surveillance System (BRFSS) data for 2013 and 2015 among a subsample of women (non-pregnant) and men age 18-44 years (N = 7,108). Physical disability categorization was based on whether mobility-related disability (MRD) was reported. Health behaviors examined were current smoking status, meeting aerobic physical activity (PA) and muscle strengthening guidelines, and dark green vegetable intake. In addition to frequencies and percentages, logistic regression analyses were used to examine associations between MRD and health behaviors separately for women and men. Results: After adjusting for covariates, women with MRD had higher odds of smoking (odds ratio [OR] = 1.77, 95% confidence interval [CI]: 1.03-3.04), not meeting aerobic PA guidelines (OR = 1.82, 95% CI: 1.13-2.92), and having lower dark green vegetable intakes (OR = 1.61, 95% CI: 1.01-2.56). Men with MRD had reduced odds of having lower dark green vegetable intake (OR = 0.50, 95% CI: 0.28-0.88). Conclusion: Women of reproductive age who have MRD face increased odds of smoking, being less physically active, and having lower dark green vegetable intake compared with nondisabled women. These areas require increased attention in health promotion programs targeting preconception health of women with MRD. [ABSTRACT FROM AUTHOR]

Female homeless youths are vulnerable to risky sex and substance use behaviors, yet they have strengths known as psychological capital. A quasi-experimental pre-post research design with repeated measures was used to examine the feasibility and preliminary efficacy of a brief intervention to enhance psychological capital, reduce health-risk behaviors, and achieve short-term behavioral goals. Study participants were 80 ethnically diverse homeless women between the ages of 18 and 23 years. Intervention participants had significant improvements in psychological capital, hope, resilience, and self-efficacy to refuse alcohol, social connectedness, and substance use (p < .05). There was a significant group by time interaction for safe sex self-efficacy; intervention participants had greater self-confidence in negotiating safer sex practices than comparison participants. At the follow-up post-test, 82% of intervention participants who remained in the study had met or exceeded their short-term goals. This brief, street-based intervention was feasible and showed preliminary efficacy. [ABSTRACT FROM AUTHOR]