Relationship Satisfaction of Intimate Partners of Persons Living With Urinary Incontinence.

PURPOSE: The purpose of this study was to examine effects of urinary incontinence (UI) on midlife women's relationships with their intimate partners, from the perspective of both women and their partners. DESIGN: A cross-sectional, mixed-methods design. SUBJECTS AND SETTING: Purposive, convenience/snowball sampling strategies and community-based recruitment strategies were used to enroll partnered, midlife women living with UI. Participants were 43 community-dwelling midlife couples residing in the southwestern United States; female participants had stress, urgency, or mixed UI by self-report. Data were also collected from their intimate partners. METHODS: Participants completed confidential mailed study packets comprising questionnaires on demographic information and lower urinary tract symptom profile, valid measures of the quality of the relationship, and open-ended questions to explore the effect of UI on the relationship in the participants' own words. The packet included several validated instruments: the Incontinence Severity Index, Couples Satisfaction Index, Sexual Quality of Life-Female/Male, Relational Ethics Scale, and Couples' Illness Communication Scale. Quantitative data were analyzed using tests of differences between groups and correlation analysis. Qualitative data were explored for themes and tested for significant differences in word choice by z-score analysis. RESULTS: We found no significant differences between women and their partners in measures of the relationship and no significant associations between UI symptom severity and relationship satisfaction. Distressed partners had significantly poorer scores on sexual quality of life (P < .001), relational ethics (P = .002), and communication about UI (P = .03). Distressed couples used significantly more words than did nondistressed couples who described the woman's withdrawal from shared activities (P = .005) and avoidance of physical intimacy (P = .003), which they attributed to UI. CONCLUSIONS: Distressed couples demonstrated the negative effects of UI on emotional and physical intimacy. Distress was attributed to how the woman coped with symptoms but not with the severity of UI symptoms.

Epinephrine Auto-Injectors for Anaphylaxis Treatment in the School Setting: A Discussion Paper.

Introduction:Anaphylaxis is a serious, life-threatening systemic allergic reaction that may occur in individuals not previously diagnosed with an allergy. Emergency first-line treatment of choice for acute anaphylaxis is intramuscular administration of epinephrine via an auto-injector. In the school setting, students with known allergies typically keep or carry an epinephrine auto-injector (EAI). For students who do not have a known allergy or for those whose personal EAIs are unavailable, an anaphylactic event could have serious adverse outcomes if an EAI is not available via an undesignated stock supply in the school.Methods:We searched the published literature from 2000 through 2018 in CINAHL, MEDLINE, and PubMed using the following search terms: anaphylaxis, school setting, epinephrine auto-injector, and food allergies. Throughout this article, undesignated stock EAIs, stock EAIs, EAI stock, and open-order EAIs are used interchangeably.Conclusion:Anaphylaxis is increasing worldwide as the incidence of food allergies increases. Although stock EAIs for students in schools can have important benefits, the availability of EAIs in the school setting is limited. Barriers to undesignated stock EAIs include the lengthy administrative process for developing school policies and protocols; gaps in nurses' self-perceived knowledge versus objective knowledge on the topic of anaphylaxis; limited resources in many school districts; and complex role demands, lack of confidence in trained staff, or insufficient school nurse staffing. It is important that epinephrine be readily available in schools. Barriers to facilitating stock EAIs include those that can be addressed directly by nurses and those that may require policy changes. Nurses, particularly those working in school settings or pediatrics, could take the lead in discussions about the benefits of stock EAIs in schools, advocating for policy changes as warranted. Fully informed nurses can be better prepared to serve as advocates in ensuring that EAIs are available in school settings.

Urinary Incontinence and Psychosocial Factors Associated With Intimate Relationship Satisfaction Among Midlife Women.

OBJECTIVE: To explore associations among symptoms of urinary incontinence, severity of symptoms, and measures of psychosocial health that may be assessed during a well-woman screening examination and the possible contribution of these variables to the relationship satisfaction of partnered midlife women living with urinary incontinence. DESIGN: Exploratory correlational design using self-report questionnaires. SETTING: Community recruitment by posted fliers, advertisements, and social media. PARTICIPANTS: Partnered women, ages 45 to 65 years, with urinary incontinence (N = 57). METHODS: Self-report measures of severity of incontinence symptoms, relationship satisfaction, self-concept/emotional health (self-esteem, body image, depression, anxiety), and relationship factors (sexual quality of life, incontinence-related communication). Data were analyzed using Spearman rho correlation with an exploration of the contribution of study factors to relationship satisfaction through standard multiple regression. RESULTS: The severity of urinary incontinence symptoms had no significant correlation with scores on relationship satisfaction or psychosocial health. Measures of self-concept/emotional health and relationship factors were significantly correlated with each other (rs = .40-.75, p < .01) and with relationship satisfaction (rs = .35-.71, p < .05). Preliminary exploration of the contribution of study factors to relationship satisfaction through exploratory regression analysis showed unique contributions from sexual quality of life (18.7%, p < .001) and depression (8.7%, p = .004). CONCLUSION: Midlife women with urinary incontinence, regardless of symptom severity, might benefit from screening for poorer sexual quality of life and mild depression symptoms because these two study factors significantly contributed to poorer intimate relationship satisfaction among this study's participants.

Mindfulness meditation in older adults with postherpetic neuralgia: a randomized controlled pilot study.

This parallel-group, randomized controlled pilot study examined daily meditation in a diverse sample of older adults with postherpetic neuralgia. Block randomization was used to allocate participants to a treatment group (n = 13) or control group (n = 14). In addition to usual care, the treatment group practiced daily meditation for six weeks. All participants completed questionnaires at enrollment in the study, two weeks later, and six weeks after that, at the study's end. Participants recorded daily pain and fatigue levels in a diary, and treatment participants also noted meditation practice. Results at the 0.10 level indicated improvement in neuropathic, affective, and total pain scores for the treatment group, whereas affective pain worsened for the control group. Participants were able to adhere to the daily diary and meditation requirements in this feasibility pilot study.

Dissemination and Implementation Research Funded by the US National Institutes of Health, 2005-2012.

Dissemination and implementation (D&I) research is a growing area of science focused on overcoming the science-practice gap by targeting the distribution of information and adoption of interventions to public health and clinical practice settings. This study examined D&I research projects funded under specific program announcements by the US National Institutes of Health (NIH) from 2005 to 2012. The authors described the projects' D&I strategies, funding by NIH Institute, focus, characteristics of the principal investigators (PIs) and their organizations, and other aspects of study design and setting. Results showed 46 R01s, 6 R03s, and 24 R21s funded totaling $79.2 million. The top funders were the National Cancer Institute and the National Institute of Mental Health, together providing 61% of funding. The majority of PIs were affiliated with Schools of Medicine or large, nonprofit research organizations and think tanks. Only 4% of projects were to PIs with appointments at Schools of Nursing, with 7% of the funding. The most commonly funded projects across all of the studies focused on cancer control and screening, substance abuse prevention and treatment, and mental health services. Typically implemented in community and organizational settings, D&I research provides an excellent opportunity for team science, including nurse scientists and interdisciplinary collaborators.

Celiac disease: a multisystem autoimmune disorder.

Just a few years ago, celiac disease was thought to be relatively rare in the United States, but recent data suggest celiac disease may affect 3 million Americans of all ages, many of whom have no diagnosis of the disease. With increased awareness of this disease among adult and pediatric primary care providers, there undoubtedly will be an increase in the number of persons being evaluated for celiac disease in outpatient diagnostic centers and gastroenterology practices. Gastroenterology nurses, therefore, need to have a thorough understanding of celiac disease to fully participate as members of the multidisciplinary team required to manage this challenging disease. This article discusses the pathogenesis, prevalence, diagnosis, clinical manifestations, management, and complications of celiac disease.