Search

lobchuk m.m., mcpherson c.j., mcclement s.e. & cheang m. (2011) A comparison of patient and family caregiver prospective control over lung cancer. Journal of Advanced Nursing 68(5), 1122-1133. Abstract Aim. This paper is a report of our secondary analysis of patient and family caregiver prospective control in lung cancer. Background. Control beliefs underlie self-care in sickness and health. Self-care often involves 'shared' activities between the afflicted individual and caregiving family and friends. However, depending on how control is perceived, conflicts can occur in decision-making thus jeopardizing optimal self-care. We need to comprehend how control beliefs compare between patients and caregivers and how their control beliefs are linked with dealing with serious illness. Methods. Based on questionnaire data collected in our larger study between September 2005 and February 2009, we conducted exploratory comparative analyses of 304 patients' and caregivers' control beliefs in managing lung cancer. Eight 5-point response items captured prospective control. Exploratory factor analysis with promax rotation was conducted to compare dyadic perceptions on the dimensionality of prospective control. We also conducted exploratory correlations between control beliefs and smoking cessation, attributional reactions, caregiver helping and symptom reports. Results. Principal component analysis identified the same factors for patients and caregivers: factor 1, Fate control and factor 2, Team control. Patient and caregiver 'Fate' and 'Team' control sub-scales were respectively associated with hope, caregiver helping and patient smoking cessation. Conclusion. Clinicians need to support, adapt or develop a philosophy of cancer care that is inclusive of partnerships, drawing on beliefs of patients and caregivers that controlling lung cancer is a team effort which in turn is tentatively linked to patient smoking cessation, positive emotions and caregiver helping. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the measurement properties of the Social Responsiveness Scale in an accelerated longitudinal sample of 4-year-old preschool children with the complementary approaches of categorical confirmatory factor analysis and Rasch analysis. Measurement models based on the literature and other hypothesized measurement models which were tested using categorical confirmatory factor analysis did not fit well and were not unidimensional. Rasch analyses showed that a 30-item subset met criteria of unidimensionality and invariance across item, person, and over time; and this subset exhibited convergent validity with other child outcomes. This subset was shown to have enhanced psychometric properties and could be used in measuring social responsiveness among preschool age children with Autism Spectrum Disorders. [ABSTRACT FROM AUTHOR]

harwood l., wilson b., sontrop j. & clark a.m. (2012) Chronic kidney disease stressors influence choice of dialysis modality. Journal of Advanced Nursing 68(11), 2454-2465. Abstract Aim. This article is a report of a study examining the relationships between chronic kidney disease stressors and coping strategies with dialysis modality. Background. People with chronic kidney disease are given information to enable dialysis modality choice. This education increases awareness and may alleviate concerns and stress. Disease-related stressors and coping may affect dialysis selection. Understanding the influence of stress and coping on dialysis choices will assist in providing responsive programmes. Reducing stress and encouraging coping may increase home dialysis which, despite economic and patient benefits, remains underused. Design. A prospective correlational design was used. Methods. Information was obtained from the Chronic Kidney Disease Stress Inventory and the Jalowiec Coping Scale in 223 individuals not on dialysis between the years 2005-2007. Data were recorded with respect to modality at dialysis initiation ( n = 76) from 2005-2010. The effects of stress, coping and patient parameters on modality selection were compared using bivariate and multivariate analyses. Results. Individuals on home dialysis vs. in-centre haemodialysis reported significantly fewer pre-dialysis stressors. Coping was not associated with dialysis modality. Individuals on in-centre haemodialysis had a lower serum creatinine, less advanced kidney disease and weighed more than those who started on a home therapy. Physiological stressors were most common and are amenable to interventions. Conclusion. Pre-dialysis stress levels predicted dialysis modality. Interventional studies are recommended to address chronic kidney disease stressors with the outcome of improving home-dialysis usage. [ABSTRACT FROM AUTHOR]

Real uptake of recommendations is at the crux of community-based fall prevention. This mixed methods intervention study investigated how knowledge of one's own fall risk influenced self-reported behaviors and beliefs about falls and fall prevention in the home by older adults. Between one-on-one semi-structured interviews, participants received their individual scores compared to age-matched normative values for the Falls Efficacy Scale, Activities-specific Balance Confidence Scale, Biodex™ Fall Risk Test, and cut scores for the Timed Up and Go and Berg Balance Scale. Change scores on the Falls Behavioural Scale for Older Adults were reviewed as norm values were not found in the literature. Findings from the fall-related assessments and interviews reiterated the complexity of falls and fall prevention in a fluctuating curve of 'awareness' comprised of 'having concern, being careful,' 'accepting,' and 'action/behavior related to fall prevention.' Despite some uptake of recommended fall prevention advice, being perceived as susceptible to falls remained unacceptable to these participants, limiting real transfer or expressed belief in fall risk. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression (PPD) reduces maternal–infant interaction quality, stresses infants and mothers, and is linked to adverse child social–emotional and cognitive developmental outcomes. Objectives: A hypothesised mechanism for these observed relationships is the stress-related over-activation of the hypothalamic–pituitary–adrenal (HPA) axis and resultant altered cortisol patterns. While cortisol levels of mothers and infants are strongly correlated, environmental, maternal, infant and maternal–infant interactive factors may also contribute to altered cortisol patterns. Thus, the objective of this study is to use Barnard’s Child Health Assessment Model to explore the influences on maternal and infant diurnal cortisol patterns for matched pairs of mothers and infants affected by postpartum depression. Method: Secondary analyses were conducted on data collected from mothers and their infants affected by symptoms of PPD (n = 53). Multiple regression models were undertaken to study mothers’ and infants’ diurnal cortisol patterns using area under the curve analysis. Results: Having a preterm child predicted both an increase in overall cortisol levels (p = .01) and a reduction in the daily decline (p = .02) in cortisol patterns for mothers. Difficult life circumstances (p = .04) also predicted a reduction in mothers’ expected daily decline in cortisol. For infants, maternal–infant interaction qualities including cognitive growth-fostering (p = .03) and socioemotional growth fostering (p = .02) reduced overall cortisol levels and increased the daily decline in cortisol, respectively. Conclusion: For mothers, preterm birth was the most robust predictor of elevated cortisol levels. For infants, more optimal maternal–infant interactions predicted lower levels of infant cortisol. Future research should examine interactions among infant temperament, maternal responsiveness and infant cortisol patterns. [ABSTRACT FROM PUBLISHER]