Search

BACKGROUND: Most nurses are called on to care for dying patients in their professional practice. Yet, ineffective educational preparation to provide this care is consistently reported. An assessment of the preparation of nursing students and associated outcomes is needed to identify the effectiveness of various components of nursing education programs. METHOD: A study design involving cross-sectional surveys of five cohorts of nursing students in a baccalaureate nursing program was implemented. End-of-life education outcomes assessed included perceived competence, attitudes, and knowledge. RESULTS: Mixed analysis of variance analyses supported significant cohort differences for attitudes and knowledge outcomes; perceived competence outcomes lacked significance. CONCLUSION: The pattern of between cohort differences identified suggests that students experience positive changes in knowledge and attitudes associated with academic progression. However, deficiencies persist that need to be addressed with targeted educational interventions. [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]

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]

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]

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 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.

Purpose: To evaluate health literacy in a cohort of 75 adolescents with sickle cell disease (SCD)., Design and Methods: This cross-sectional, descriptive correlational study included assessment of demographic measures and appraisal of data resulting from completion of the REALM-Teen and Newest Vital Sign (NVS) instruments by 75 Black, non-Hispanic adolescents with SCD. Convenience sampling was utilized. Inclusion criteria were a diagnosis of one of the four primary genotypes of SCD and age 10-19years., Results: Thirty-seven males and 38 females were recruited for the study. Their mean age was 14.7years (SD=2.2; range 8.1). Their grade level ranged from 4 to 12 (mean 8.7; SD=2.2). Scores on the REALM-Teen ranged from 12 to 66 (mean 53.7; SD=12.8). Scores on the NVS ranged from 0 to 6 (mean 2.37; SD=1.33). These health literacy scores were lower using both the REALM-Teen and the NVS instruments when compared to scores in all healthy adolescents and adults. Current grade level and health literacy scores showed a moderately high positive correlation (r=0.52, p<0.01). Health literacy scores were also significantly positively correlated with age (r=0.49, p<0.01) and income (r=0.37, p<0.01)., Conclusions: Health literacy in adolescents with SCD is suboptimal. Future research should include identifying facilitators and barriers to health literacy levels in a larger cohort of adolescents with SCD., Practice Implications: Health literacy is a potential facilitator of successful health outcomes for all adolescents. This study lays a solid foundation for future adolescent health literacy initiatives., (Copyright © 2017 Elsevier Inc. All rights reserved.)