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The purpose of the study was to identify factors that influenced family caregivers' decisions to participate in an intervention research study. In interviews conducted before and after the intervention, caregivers (n=21) described reasons for participation. A focused content analysis was used to examine responses. Themes that emerged included: (a) caregivers recognized a need for help; (b) expectations and motivations toward change; (c) recognition of self worth as caregivers; (d) timeliness of recruitment strategies; (e) support of research staff affected recruitment; and (f) caregivers recognized the benefits of participation. These findings support the importance of many different strategies for effective recruitment of caregivers in future studies. (c) 2007 Wiley Periodicals, Inc. Res Nurs Health 30: 347-355, 2007. [ABSTRACT FROM AUTHOR]

Objective: This feasibility study evaluated a cognitive-behavioral intervention designed to provide post-rehabilitation informational, decisional, and interpersonal sup-port by a rehabilitation nurse and an expert peer for six months, in Hispanics and non-Hispanics with a new spinal cord injury (SCI). Background/ Variables of Interest: Following SCI, shortened inpatient rehabilitation minimizes the time for learning and adjustment. Investigators designed an intensive individualized telephone intervention to improve patient outcomes of hope, adjustment, and quality of life (QOL). Method: A longitudinal, descriptive design was used. Ten adults, six Hispanics and four non-Hispanics participated. Data analysis included descriptive statistics and linear multilevel regression analysis. Results: Overall, a positive trend in hope, adjustment and QOL occurred during the six months. However, the pattern of responses differed between Hispanics and non-Hispanics. Discussion: This study demonstrated that access to appropriate knowledge and decision making supports in a population with limited mobility, potential social isolation, and a sudden and urgent need for new, complex information and skills, has promise in preventing costly complications. [ABSTRACT FROM AUTHOR]

The overall purpose of this qualitative study was to describe how patients with AIDS (PWAs) transcend the emotional and physical suffering of their illness. Content analysis of the interviews of 5 PWAs resulted in 3 main themes: creating a meaningful life pattern, connectedness, and self-care. The results of this study provide presumptive evidence that PWAs can transcend the suffering associated with a life-threatening illness and live meaningful and productive lives. Nurses who anticipate actual and potential growth in PWAs will be able to validate such experiences and feelings and encourage further development. [ABSTRACT FROM AUTHOR]

Purpose: The study was to understand the facilitators and barriers to exercise using exergames among assisted living residents, particularly in the area of cognitive, physical, and psychosocial effects., Design: Self-efficacy theory was incorporated into the design of the Wii Fit exergaming program., Method: Fifteen participants (mean age: 87.07 ± 3.92) received the program twice a week for 4 weeks. Semi-structural individual interview was conducted after the program. Interview responses were analyzed using basic content analysis methods., Findings: Five themes emerged that facilitated participants? desire to exercise: (1) health and mobility; (2) increased alertness; (3) elevated mindset; (4) social interaction; and (5) structured program. Barriers to engage in exercise included: (1) age- or health-related impairments to exercise; and (2) unpleasant experiences related to exercise., Conclusions: An intervention incorporating self-efficacy and Wii exergames did result in the identification of cognitive, physical, and psychosocial benefits and barriers to exercise., (© 2015 Association of Rehabilitation Nurses.)

The purpose of this study was to investigate the physical and psychosocial effects of the Wii Fit exergames incorporating self-efficacy theory on assisted living residents. The study was a quasi-experimental pre/post-test design. Thirty-two participants were recruited from two assisted living facilities. Sixteen participants received the Wii Fit exergames incorporating self-efficacy theory twice a week for 4 weeks. The other participants received a health education program. Physical function, fear of falling, depression, and quality of life were evaluated. T tests were used for data analysis. After the 4-week intervention, the Wii Fit group showed significant improvements in balance (p < .01), mobility (p < .01), and depression (p < .05). The education group showed no significant improvement in any of the outcomes. Integrating concepts of self-efficacy theory with the exergames show promise as a potential tool to improve and maintain physical and psychosocial health for older adults., (© The Author(s) 2014.)

The physical and psychosocial benefits of exergames have been reported in various literature. A pre-posttest, single-group design was used to test the effects of an exergames-based intervention on cognition, depression, and health-related quality of life (QOL) in assisted living residents. Bandura's self-efficacy theory was applied. Seven residents (mean age = 86, SD = 5 years) participated in the program two times per week for 8 weeks. Outcome measures included cognition, depression, and health-related QOL. No statistically significant differences were found in any of the outcomes after the intervention. A tendency toward improved cognition occurred, but the outcomes of depression and health-related QOL did not follow a similar trend. However, improved socialization and motivation to exercise were reported. Continued research is needed to investigate the cognitive and psychosocial effects of exergames on this population. Nurses can collaborate with other health care professionals to engage residents in exercise and thus improve residents' QOL., (Copyright 2014, SLACK Incorporated.)

The purpose of this study was to examine the feasibility of a self-efficacy based intervention using Wii exergames in assisted living residents. The study was a single-group pre- and post-test design. Seven older adults (aged 80-94 years) were instructed to engage in exergames twice a week for 8 weeks. Physical function (balance, mobility, and walking distance), fear of falling, self-efficacy for exercise, and outcome expectations for exercise were evaluated. All participants had enjoyable experiences and no serious adverse events were reported. Participants had significant improvement on balance. Although not significant, there were trends indicating that participants improved mobility, walking endurance, and decreased fear of falling. The use of Wii exergames was an acceptable, safe, and potentially effective approach to promote physical activity in older adults. Findings provide support for the applications of integrating self-efficacy theory into exergames as a mechanism to encourage older adults to engage in exercise., (Copyright © 2013 Mosby, Inc. All rights reserved.)

Little is known about the experiences and needs of family caregivers of Latino/Hispanic individuals with spinal cord injury (SCI) during the early years of recovery. The purpose of this grounded theory study was to describe the experiences and identify the informational, decisional, interpersonal, and resource support needs of family caregivers of newly injured Latino/Hispanic individuals with SCI during the first 2 years after undergoing rehabilitation. "Resolving to go forward" was the core category that emerged from two simultaneous processes of "learning to care for" and "getting through" during the initial years as the primary informal caregiver. Most caregivers felt alone and abandoned after the injured person returned home, and experienced barriers to services and resources primarily because of language issues and economic status. We recommend that researchers develop and evaluate culturally appropriate, informal caregiving models to improve outcomes for both Latino individuals with SCI and their family caregivers.

Addressing quality of life (QOL) issues in the spinal cord injured (SCI) population is imperative as the majority survive their initial injury and longevity now approaches that of the general population. The purpose of this mixed method, descriptive, longitudinal feasibility study was to describe and compare QOL in 10 adult SCI individuals and their family caregivers (FCs) during the initial 6 months following rehabilitation. Instruments used were the SF-36 and two horizontal visual analog scales, one for pain and one for QOL. Participants completed the instruments and a face-to-face in-depth interview at 1-, 3-, and 6-months following inpatient rehabilitation. SCI individuals reported low physical function, role physical (RP), and role emotional (RE) scores on the SF-36, while reporting high general health (GH), mental health and social functioning on the SF-36. FCs reported lower RP, GH and vitality scores, while reporting higher physical functioning and RE scores. On the visual analog scales, persons with SCI reported lower QOL while FCs reported more pain at 3 and 6 months. This study suggests that more work is needed to identify interventions which could enhance QOL during the transition from rehabilitation to home for SCI individuals and their FCs.

A study was undertaken to describe the meaning, process, and consequences of nurse caring from the perspective of persons with spinal cord injuries (SCI) during rehabilitation. The constant comparative method, or grounded theory, was used in this prospective, exploratory project. In-depth tape-recorded interviews were conducted with 22 participants throughout their initial rehabilitation stay. A process of knowledge acquisition and decision making, facilitated by nurses and therapists in special caring relationships with the persons with SCI, resulted in outcomes of well-being, self-care, autonomy in decision making, independence, and hope, all of which contributed to the persons with SCI's reintegration of self before their discharge from inpatient rehabilitation.

The establishment of special caring relationships between spinal cord injured individuals (SCI) and nurses or therapists during rehabilitation creates unique ethical dilemmas. This paper will explore the practical and ethical implications for health care professionals who feel a moral imperative, compelled by their special relationship with a particular SCI individual, to "break the rules" within a rehabilitation bureaucracy in order to provide individualized health care. From the staff perspective two issues will be examined: the status of special relationships in a health care organization and the ability to maintain one's personal and professional standards in a managed care environment. From the administrative perspective two ethical issues will be explored: the challenge of pursuing the good of the patient and the organization while navigating between the public and private spheres of health care in a health care system that values standardization.

Pulmonary complications are the major contributor to mortality and morbidity following spinal cord injury (SCI), especially during the first year. Patients who are at increased risk of pulmonary complications include SCI individuals with cervical and high thoracic injuries, patients with unstable injuries who must be immobilized, patients with multiple injuries and individuals over the age of 65 years. Although research exists on many of the elements of pulmonary hygiene, there is a paucity of systematic research linking therapeutic interventions with patients outcomes during the acute phase following SCI. This area is rich for the development of collaborative empirical studies which contribute to the science of preventing pulmonary complications following acute SCI. Research is needed which tests specific pulmonary hygiene protocols in relation to patient outcomes during the acute phase of SCI and in the early months after the patient returns home.

Nurses and other healthcare providers have little research to guide them on specific interventions and attitudes which expedite the attainment of rehabilitation outcomes by spinal cord injured (SCI) individuals and their successful return to the community (Fuhrer, 1994; Whiteneck, 1994). Acquisition of knowledge is required during rehabilitation to learn self-care and decision-making which is essential to long term survival following SCI. However, skills that patients and families are able to accomplish in rehabilitation are often not able to be translated into the home environment (White & Holloway, 1990). The process of learning self-care and decision-making needs to be more clearly elucidated, so more effective interventions can be designed which can improve problem-solving and lead to enhanced well-being and quality of life. The purpose of this qualitative study was to describe the meaning, process and consequences of caring during rehabilitation from the perspective of the SCI individual. This paper will report on the findings from one research question: How is the process of a developing caring relationship perceived by SCI individuals during rehabilitation? The theoretical foundation of caring for this study was synthesized from philosophical, ethical, feminist, and nursing literature. A purposive sample of adults with traumatic SCI were interviewed at least once during their initial rehabilitation stay. Twenty interviews were conducted with fifteen participants at various times during their rehabilitation stay over a six month period. The core category of "getting back together" or reintegration of self, which was the major work of rehabilitation, was accomplished with nurses and therapists who were perceived as caring. The process of a developing caring relationship was conceptualized, from participants' descriptions in three phases: learning the other, learning what I need to know, and letting me find out. During each phase reciprocal behaviors occurred between the patient and the caregiver resulting in intermediate outcomes, which facilitated movement to the next phase. Consequences of these caring relationships were: well-being, self-care, autonomy, independence, and hope. Caring by rehabilitation professionals was perceived by SCI individuals as central to recovery and to a positive attitude toward disability.

Continuous cerebral blood flow monitors are being used in critically ill neuroscience patients to assess blood flow in vulnerable regions of the brain and to evaluate the effects of treatments on these areas. Neuroscience nurses need to interpret cerebral blood flow values in relation to the many other physiologic parameters which are monitored in this population. Case studies are used to illustrate various patterns of regional blood flow in response to brain insults and therapeutics. Research implications of continuous cerebral blood flow monitoring are explored.