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1.
Clin Nurse Spec ; 38(2): 107-109, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38364072

RESUMO

PURPOSE/OBJECTIVES: We aim to explore Current Procedural Terminology (CPT) codes for caregiving training services and their potential impacts on caregivers of people living with dementia. DESCRIPTION OF THE PROJECT/PROGRAM: In response to the growing need for support for caregivers of people living with physical and mental health issues, CPT codes for caregiving training services will be activated for the calendar year 2024. These codes cover (1) family group behavior management and modification training services and (2) caregiver training for techniques to help patients maintain their quality of life. Caregivers will access such training support through the CPT codes provided by treating practitioners. The duration of training will vary by code. OUTCOME: Implementing CPT codes for caregiver training services highlights the vital role of caregivers in patient care. This support may improve their skills and communication with healthcare providers. However, timing and accessibility in care delivery need clarification, especially for caregivers of people living with dementia. Regular skill assessment and culturally competent care are essential. Before providing the service, provider training may also promote person-centered care, benefiting patients and their caregivers. CONCLUSION: Activating CPT codes for caregiving training services may enhance caregivers' support and skills, including dementia care.


Assuntos
Cuidadores , Demência , Humanos , Cuidadores/psicologia , Demência/psicologia , Qualidade de Vida , Pessoal de Saúde , Poder Psicológico
2.
Alzheimer Dis Assoc Disord ; 38(1): 22-27, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38109352

RESUMO

OBJECTIVE: Using the metadata collected in the digital version of the Self-Administered Gerocognitive Examination (eSAGE), we aim to improve the prediction of mild cognitive impairment (MCI) and dementia (DM) by applying machine learning methods. PATIENTS AND METHODS: A total of 66 patients had a diagnosis of normal cognition (NC), MCI, or DM, and eSAGE scores and metadata were used. eSAGE scores and metadata were obtained. Each eSAGE question was scored and behavioral features (metadata) such as the time spent on each test page, drawing speed, and average stroke length were extracted for each patient. Logistic regression (LR) and gradient boosting models were trained using these features to detect cognitive impairment (CI). Performance was evaluated using 10-fold cross-validation, with accuracy, precision, recall, F1 score, and receiver operating characteristic area under the curve (AUC) score as evaluation metrics. RESULTS: LR with feature selection achieved an AUC of 89.51%, a recall of 87.56%, and an F1 of 85.07% using both behavioral and scoring. LR using scores and metadata also achieved an AUC of 84.00% in detecting MCI from NC, and an AUC of 98.12% in detecting DM from NC. Average stroke length was particularly useful for prediction and when combined with 4 other scoring features, LR achieved an even better AUC of 92.06% in detecting CI. The study shows that eSAGE scores and metadata are predictive of CI. CONCLUSIONS: eSAGE scores and metadata are predictive of CI. With machine learning methods, the metadata could be combined with scores to enable more accurate detection of CI.


Assuntos
Disfunção Cognitiva , Acidente Vascular Cerebral , Humanos , Metadados , Sensibilidade e Especificidade , Disfunção Cognitiva/diagnóstico , Aprendizado de Máquina
3.
Nurs Res ; 72(6): 489-494, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37890162

RESUMO

BACKGROUND: The prevalence of hypertension is 55% among African American/Black women, who have a higher risk for poor health outcomes compared to women from other racial and ethnic groups, in part because of uncontrolled blood pressure. Previous research results suggest that peers may positively influence self-management of chronic conditions like hypertension. However, few studies have described the personal characteristics of peers in the health social networks of Black women. OBJECTIVE: This substudy aimed to examine health social networks and describe the peers' characteristics, as reported by a convenience sample of Black women with hypertension. METHODS: In this analysis of data from a larger study, 94 Black women with hypertension attending a church conference participated in a cross-sectional, descriptive study. Their mean age was 59 years, and their mean systolic blood pressure was 143 mm Hg. All participants completed a survey to gather data about (a) the characteristics of individuals they discussed health matters with (their peers or health social network) and (b) their perceptions about hypertension status and knowledge of hypertension among the peers in their health social network. RESULTS: Collectively, participants from the larger study named a total of 658 peers who were part of their health social networks; the mean health social network size was six peers. The peers were mostly women, Black, family members, and, on average, 54 years old. The participants discussed hypertension with 71% of the peers, reported that 36% had hypertension, and felt that 67% were somewhat or very knowledgeable about the condition. A small, positive correlation existed between the participants' health social network size (number of peers named) and their systolic blood pressure levels. DISCUSSION: The health social network peers were similar to those in the larger study, with most of the same gender, race, and age. The findings of this analysis may be used to help practitioners and scientists guide patients in building health social networks for support in self-managing hypertension and conducting future studies to examine the best strategies for developing and using health social networks to improve health outcomes and reduce health disparities.


Assuntos
Educação em Saúde , Hipertensão , Rede Social , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Negro ou Afro-Americano , Estudos Transversais , Etnicidade , Hipertensão/etnologia , Hipertensão/terapia , Grupo Associado
4.
Nurs Res ; 72(5): 404-408, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37625184

RESUMO

BACKGROUND: At-home self-collection of specimens has become more commonplace because of measures taken in response to the coronavirus pandemic. Self-collection of hair cortisol is important because chronic stress is present in many populations, such as older adults living with Alzheimer's disease and their family caregivers. For the evaluation of chronic stress, scalp hair can be used as a predictive biomarker because it examines the cumulative, retrospective stress from previous months. OBJECTIVES: The aim of the paper is to provide a study procedure for at-home, scalp hair self-collection for cortisol concentration analysis from dyads consisting of a person living with Alzheimer's disease and their family caregiver. METHODS: After informed electronic consent is obtained, a package containing the necessary tools for self-collection of hair samples from the dyad is mailed to the participant's home. Participants are provided detailed print and video multimedia guides outlining how to obtain the hair samples. Ideally, the hair samples are obtained during the virtual data collection meeting with research personnel. Participants mail back the hair sample in a prepaid package to the biomedical laboratory for analysis. DISCUSSION: At-home, self-collection of hair provides potential advantages such as reduced participant burden, especially for vulnerable populations where transportation and different environments are challenging. At-home sample collection options may increase research participation and can be applied to multiple research foci. Research considerations for dyads, such as people living with Alzheimer's disease and their caregivers, are discussed.


Assuntos
Doença de Alzheimer , Hidrocortisona , Humanos , Idoso , Hidrocortisona/análise , Estudos Retrospectivos , Cuidadores , Cabelo/química
5.
Nurs Outlook ; 71(5): 102027, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37579575

RESUMO

BACKGROUND: The challenge to increase the diversity, inclusivity, and equity of nurse scientists is a critical issue to enhance nursing knowledge development, health care, health equity, and health outcomes in the United States. PURPOSE: The purpose of this paper is to highlight the current nurse scholars in the Robert Wood Johnson Foundation (RWJF) Harold Amos Medical Faculty Development Program (AMFDP). DISCUSSION: Profiles and the programs of research and scholarship of the current AMFDP nurse scholars are described and discussed. Scholars share lessons learned, and how the AMFDP program has influenced their thinking and commitments to future action in service of nursing science, diversity efforts, legacy leadership, issues of health equity. CONCLUSION: RWJF has a history of supporting the development of nursing scholars. AMFDP is an example of legacy leadership program that contributes to a culture of health and the development of next-generation nursing science scholars.


Assuntos
Currículo , Docentes de Medicina , Humanos , Estados Unidos , Avaliação de Programas e Projetos de Saúde , Docentes de Enfermagem , Fundações , Liderança , Desenvolvimento de Programas
6.
J Psychosoc Nurs Ment Health Serv ; 61(8): 51-59, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36989479

RESUMO

Opioid use disorder (OUD) is widely prevalent in the United States and there are high levels of comorbidity between OUD and mental illnesses, such as depression, anxiety, and posttraumatic stress disorder. Psychotherapy, in addition to medication-assisted therapy, are considered important components of long-term OUD treatment. Sudarshan Kriya Yoga (SKY) is a breathing-based mind-body intervention that has been demonstrated to have multiple physiological and psychological benefits. In the current study, participants (N = 8) recruited from a rural community were offered SKY in addition to treatment-as-usual. Physical and psychological well-being were measured using the Behavior and Symptom Identification Scale-24, Short Form-36, Perceived Stress Scale, and participant logs and journals. Of eight participants, seven (87.5%) successfully completed the SKY intervention. Compared to baseline, there was a significant decrease in substance use cravings (p = 0.04) and depression (p = 0.01). In addition, physical functioning and emotional well-being significantly increased after SKY. SKY demonstrated efficacy in improving physical and social functioning along with enhancing mental and emotional well-being. Larger-scale trials should be performed to validate these findings. [Journal of Psychosocial Nursing and Mental Health Services, 61(8), 51-59.].


Assuntos
Meditação , Transtornos Relacionados ao Uso de Opioides , Yoga , Humanos , Projetos Piloto , Fissura
7.
Front Pain Res (Lausanne) ; 3: 926459, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36061416

RESUMO

Recruitment and retention of participants for pain-related neuroimaging research is challenging and becomes increasingly so when research participants have a diagnosis of Alzheimer's disease and related dementias (ADRD). This article shares the authors' recommendations from several years of successful recruitment and completion of pain-related neuroimaging studies of people living with ADRD and includes supportive literature. While not an exhaustive list, this review covers several topics related to recruitment and retention of participants living with ADRD, including community engagement, capacity to consent, dementia diagnostic criteria, pain medication and other study exclusion criteria, participant and caregiver burden, communication concerns, and relationships with neuroimaging facilities. Threaded throughout the paper are important cultural considerations. Additionally, we discuss implications of the coronavirus (COVID-19) pandemic for recruitment. Once tailored to specific research study protocols, these proven strategies may assist researchers with successfully recruiting and retaining participants living with ADRD for pain-related neuroimaging research studies toward improving overall health outcomes.

8.
Geriatrics (Basel) ; 7(3)2022 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-35645276

RESUMO

(1) Background: African Americans experience high rates of psychological stress and hypertension, which increases their risk of cardiovascular disease with age. Easy-to-collect psychological and biological stress data are valuable to investigations of this association. Hair cortisol concentration (HCC), as a proxy biomarker of chronic stress exposure, provides such advantages in contrast to collection of multiple daily samples of saliva. Objective: To examine the relationships among HCC, perceived stress, mental well-being, and cardiovascular health (systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP)). (2) Methods: Cross-sectional secondary data (N = 25) were used from a mind-body intervention study in hypertensive African Americans ages 65 and older. Data included HCC, a four-item perceived stress scale, SF-36 mental components summary, and SBP/DBP. SBP + 2 (DBP)/3 was used to calculate MAP. (3) Results: The relationship between mental well-being and perceived stress (r = -0.497, p ≤ 0.01) and mental well-being and DBP (r = -0.458, p = 0.02) were significant. HCC change was not significant. In a regression model, every unit increase in well-being predicted a 0.42 decrease in DBP (ß = -0.42, 95% CI (-0.69-0.15)) and a 1.10 unit decrease in MAP (ß = -1.10, 95% CI (-1.99-0.20)). (4) Conclusions: This study contributes to the knowledge of physiologic data regarding the relationship between MAP and well-being. Findings from this study may aid in the development of interventions that address mental well-being and cardiovascular health in African American older adults with hypertension.

9.
Nurs Res ; 71(4): 303-312, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35302958

RESUMO

BACKGROUND: Uncontrolled blood pressure (BP) rates are persistently high among African Americans with hypertension. Although self-management is critical to controlling BP, little is known about the brain-behavior connections underlying the processing of health information and the performance of self-management activities. OBJECTIVES: In this pilot study, we explored the associations among neural processing of two types of health information and a set of self-management cognitive processes (self-efficacy, activation, decision-making, and hypertension knowledge) and behaviors (physical activity, dietary intake, and medication taking) and health status indicators (BP, health-related quality of life, anxiety, and depression). METHODS: Using a descriptive cross-sectional design, 16 African Americans with uncontrolled hypertension (mean age = 57.5 years, 68.8% women) underwent functional magnetic resonance imaging to assess activation of two neural networks, the task-positive network and the default mode network, and a region in the ventromedial prefrontal cortex associated with emotion-focused and analytic-focused health information. Participants completed self-reports and clinical assessments of self-management processes, behaviors, and health status indicators. RESULTS: Our hypothesis that neural processing associated with different types of health information would correlate with self-management cognitive processes and behaviors and health status indicators was only partially supported. Home diastolic BP was positively associated with ventromedial prefrontal cortex activation ( r = .536, p = .09); no other associations were found among the neural markers and self-management or health status variables. Expected relationships were found among the self-management processes and behaviors and health status indicators. DISCUSSION: To advance our understanding of the neural processes underlying health information processing and chronic illness self-management, future studies are needed that use larger samples with more heterogeneous populations and additional neuroimaging techniques.


Assuntos
Hipertensão , Autogestão , Negro ou Afro-Americano/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Qualidade de Vida , Autogestão/psicologia
10.
Worldviews Evid Based Nurs ; 19(1): 6-15, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35137506

RESUMO

BACKGROUND: Hypertension is a leading cause of cardiovascular disease (CVD) and affects nearly one in two adults in the United States when defined as a blood pressure of at least 130/80 mm Hg or on antihypertensive medication (Virani et al., 2021, Circulation, 143, e254). Long-standing disparities in hypertension awareness, treatment, and control among racial and ethnic populations exist in the United States. High-quality evidence exists for how to prevent and control hypertension and for the role nurses can play in this effort. In response to the 2020 Surgeon General's Call to Action to Control Hypertension, nursing leaders from 11 national organizations identified the critical roles and actions of nursing in improving hypertension control and cardiovascular health, focusing on evidence-based nursing interventions and available resources. AIMS: To develop a unified "Call to Action for Nurses" to improve control of hypertension and cardiovascular health and provide information and resources to execute this call. METHODS: This paper outlines roles that registered nurses, advanced practice nurses, schools of nursing, professional nursing organizations, quality improvement nurses, and nursing researchers can play to control hypertension and prevent CVD in the United States. It describes evidence-based interventions to improve cardiovascular health and outlines actions to bring hypertension and CVD to the forefront as a national priority for nursing. LINKING EVIDENCE TO ACTION: Evidence-based interventions exist for nurses to lead efforts to prevent and control hypertension, thus preventing much CVD. Nurses can take actions in their communities, their healthcare setting, and their organization to translate these interventions into real-world practice settings.


Assuntos
Prática Avançada de Enfermagem , Doenças Cardiovasculares , Hipertensão , Adulto , Pressão Sanguínea , Doenças Cardiovasculares/prevenção & controle , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Melhoria de Qualidade , Estados Unidos
11.
Worldviews Evid Based Nurs ; 19(1): 64-72, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35064763

RESUMO

BACKGROUND: Hypertension rates are disproportionately higher among Black or African Americans (Black/African American) compared to other racial and ethnic groups in the United States. However, research on self-management strategies to control hypertension through healthy eating such as the Dietary Approaches to Stop Hypertension (DASH), and ketogenic diets has underexplored the use of dietary strategies among older Black/African American adults. In reporting contemporary challenges with implementing dietary strategies targeting blood pressure control among Black/African American older adults living with hypertension, this study addresses a clear need. AIMS: Prior research has only partially addressed the challenges older Black/African Americans face in implementing and maintaining dietary strategies to control hypertension, therefore the current study aimed to address this gap by reporting contemporary challenges, as reported by a sample of Black/African American older adults living with hypertension. METHODS: Nineteen Black/African American older adults living with hypertension participated in a focus group. An interview guide with open-ended questions on dietary approaches to self-management hypertension was used to guide data collection. Responses were audio-recorded, transcribed verbatim, and interpreted using qualitative thematic analysis. RESULTS: Study participants were 71.6 years (SD = 8.3), 87.1% were women, and all were self-identified as Black/African American. Overall, participants shared that they were interested in improving their hypertension self-management skills. They expressed uncertainty about dietary strategies related in part to a lack of knowledge about incorporating or excluding certain foods and adhering to complex dietary recommendations. Participants also related financial concerns about accessing the recommended foods to control hypertension and expressed confusion about how to manage hypertension alongside other comorbidities. LINKING EVIDENCE TO ACTION: This study highlights several barriers that Black/African American older adults face (lack of dietary knowledge, lack of financial resources, and unique barriers to managing multiple comorbid health conditions), which often pose simultaneous and intersecting barriers to managing hypertension using existing evidence-based dietary strategies.


Assuntos
Hipertensão , Autogestão , Negro ou Afro-Americano , Idoso , Coleta de Dados , Feminino , Grupos Focais , Humanos , Hipertensão/terapia , Estados Unidos
12.
Explore (NY) ; 18(2): 234-239, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-33736906

RESUMO

INTRODUCTION: African Americans over the age of 60 years face disproportionate risk of developing hypertension, which can be mitigated with lifestyle changes. This study examines the acceptability and cost of a patient-centered, co-created health education intervention with older African Americans living with hypertension. METHODS: Twenty women participated in this study that included four weekly, two-hour group sessions centered on hypertension knowledge and calibration of home blood pressure monitors, stress and interpersonal relationship management, sleep and pain management, and healthy eating. The study took place in the Midwest United States. RESULTS: Descriptive statistics were used to analyze acceptability data that included attendance and a brief investigator-generated questionnaire. Twenty women were enrolled. Sixteen participants attended all four sessions, all reported they intended to continue using the intervention and felt it fit within their culture, routine, and self-care practices. The estimated cost of conducting the intervention was $227.00 (U.S. dollars) per participant. CONCLUSIONS: The co-created health education intervention was acceptable. Given the dire need for cost-effective interventions to improve the adoption of health promoting self-care management behavior, to reduce the prevalence of hypertension in African Americans, the results of this study have implications for future research and practice.


Assuntos
Negro ou Afro-Americano , Hipertensão , Feminino , Educação em Saúde , Humanos , Hipertensão/terapia , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos
13.
Nurs Open ; 9(2): 942-949, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34165251

RESUMO

AIM: The purpose of this manuscript is to summarize research on how experimental pain is experienced by adults with Alzheimer's disease (AD) and to translate results into implications for nurses. DESIGN: This discursive review synthesizes the results of three previous research studies exploring experimental pain in adults with AD. METHODS: Using a series of fictional clinical vignettes, the authors discuss how the results from three previous papers using acute experimental pain can potentially be translated into clinical practice. The authors also introduce the reader to the concept of research-related psychophysics using introductory definitions and concepts with the impetus to encourage other nurses to consider this research methodology. RESULTS: Pain characteristics in AD that differ from cognitively intact controls must be explored to properly address pain in this population. Nurses are well positioned to address these issues in order to provide a high quality of care to adults with AD.


Assuntos
Doença de Alzheimer , Doença de Alzheimer/terapia , Humanos , Dor/etiologia , Medição da Dor , Psicofísica
15.
J Adv Nurs ; 77(5): 2519-2529, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33576064

RESUMO

AIM: The aim of this study is to develop a Smarthealth system of monitoring, modelling, and interactive recommendation solutions (for caregivers) for in-home dementia patient care that focuses on caregiver-patient relationships. DESIGN: This descriptive study employs a single-group, non-randomized trial to examine functionality, effectiveness, feasibility, and acceptability of the novel Smarthealth system. METHODS: Thirty persons with Alzheimer's Disease or related dementia and their family caregivers (N = 30 dyads) will receive and install Smarthealth technology in their home. There will be a 1-month observation phase for collecting baseline mood states and a 2-month implementation phase when caregivers will receive stress management techniques for each detected, negative mood state. Caregivers will report technique implementation and usefulness, sent via Ecological Momentary Assessment system to the study-provided smartphone. Caregivers will provide daily, self-reported mood and health ratings. Instruments measuring caregiver assessment of disruptive behaviours and their effect on caregivers; caregiver depressive symptoms, anxiety and stress; caregiver strain; and family functioning will be completed at baseline and 3 months. The study received funding in 2018 and ethics board approval in 2019. DISCUSSION: This study will develop and test novel in-home technology to improve family caregiving relationships. Results from this study will help develop and improve the Smarthealth recommendation system and determine its usefulness, feasibility, and acceptability for persons with dementia and their family caregiver. IMPACT: The Smarthealth technology discussed will provide in-home stress reduction resources at a time when older adults may be experiencing increasingly high rates of isolation and anxiety and caregiver dyads may be experiencing high levels of relationship strain. TRIAL REGISTRATION: This study was registered with Clinical Trials.gov (Identifier NCT04536701).


Assuntos
Doença de Alzheimer , Demência , Idoso , Ansiedade , Cuidadores , Humanos , Tecnologia
16.
Front Pain Res (Lausanne) ; 2: 780338, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35295420

RESUMO

This brief report details a pilot analysis conducted to explore racial differences in pain sensitivity and unpleasantness between cognitively healthy Black and White adults, stratified by sex. A total of 24 cognitively healthy adults (12 Black and 12 White) from two completed studies were matched by age and sex, and divided into two groups based on race. Stratified analyses by sex demonstrated that Black females reported experiencing pain intensity ratings of all three intensity sensations at lower temperatures than White females. These findings will inform future research studies to determine if these results hold true in a fully-powered sample and should include mixed methodologies, incorporating neuroimaging data to further assess this phenomenon. Improving pain assessment and management across racial/ethnic groups will help healthcare providers such as nurses and physicians to ensure optimal quality of life for all.

17.
J Am Geriatr Soc ; 69(3): 773-778, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33227157

RESUMO

OBJECTIVES: Hypertension increases the risk of developing Alzheimer's disease or related dementias. This pilot study's purpose was to examine the feasibility and acceptability of a novel intervention, Mindfulness in Motion (MIM) and Dietary Approaches to Stop Hypertension DASH (MIM DASH), to improve diet, mindfulness, stress, and systolic blood pressure (BP) in older African Americans with mild cognitive impairment (MCI) and hypertension. DESIGN: Cluster randomized controlled trial. SETTING: Intergenerational community center in a large metropolitan area. PARTICIPANTS: African Americans with MCI and hypertension. Participants were divided into six groups randomized 1:1:1 to the MIM DASH group, attention only (non-hypertensive education) group, or true control group. The MIM DASH and attention only interventions were delivered in 8-weekly 2 hour group sessions. MIM included mindful movements from chair/standing, breathing exercises, and guided meditation. The DASH component used a critical thinking approach of problem solving, goal setting, reflection, and self-efficacy. The true control group received a DASH pamphlet at the end. MEASUREMENTS: Feasibility was tracked through enrollment and attendance records; acceptability was assessed through interviews. Blood pressure was measured using the Omron HEM-907XL Monitor. Dietary intake was measured by DASH-Q. Mindfulness was measured by the Cognitive and Affective Mindfulness Scale. Stress was measured by the Perceived Stress Scale. MCI was determined using the Self-Administered Gerocognitive Examination. Data were collected at baseline and 3-months. RESULTS: Median session attendance was six for the MIM DASH group and six for the attention only group. There were no changes in diet, mindfulness, or stress. There was a clinically significant reduction in systolic BP in the MIM DASH group (-7.2 mmHg) relative to the attention only group (-.7), and no change between the MIM DASH and true control groups. CONCLUSION: Results indicate that the MIM DASH intervention was feasible and culturally acceptable in African Americans with hypertension and MCI.


Assuntos
Disfunção Cognitiva/complicações , Abordagens Dietéticas para Conter a Hipertensão/métodos , Hipertensão/complicações , Atenção Plena/métodos , Negro ou Afro-Americano , Idoso , Feminino , Humanos , Masculino , Projetos Piloto
18.
Nurs Res ; 69(5): 331-338, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32496401

RESUMO

BACKGROUND: Racial discrimination is one of many barriers experienced by African Americans that interfere with health self-care management. Discrimination stress may decrease the tendency for individuals to resonate with the social-emotional appeals embedded in persuasive health information, which are known to play a key role in producing behavior change. Understanding the neurobehavioral underpinnings of discrimination stress experienced by African Americans may help reduce or resolve this important health disparity. OBJECTIVES: The purpose of this secondary analysis was to examine the association between neural processing of health information and perceived discrimination. In particular, we focused on three previously identified measures of health information processing associated with distinct brain areas: analytic network, empathy network, and the ventral medial prefrontal cortex. METHODS: Data were obtained from 24 African Americans enrolled in a blood pressure self-care management study. Participants completed surveys assessing racial discrimination and global stress, as well as a 40-minute functional magnetic resonance imaging protocol used to measure neural activation associated with processing different types of health information. RESULTS: Discrimination stress was significantly related to reduced activation of the empathy network and ventral medial prefrontal cortex, whereas there was a nonsignificant positive relationship with activity in the analytic network. DISCUSSION: Uncovering associations between patient experiences, such as racial discrimination, and their neural processing of health information can lead to the development of tailored health messages and self-care management interventions. This may inform strategies to close the gap on health outcomes.


Assuntos
Negro ou Afro-Americano/psicologia , Racismo/psicologia , Adulto , Negro ou Afro-Americano/etnologia , Idoso , Estado Terminal/epidemiologia , Estado Terminal/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Racismo/etnologia , Inquéritos e Questionários
19.
Nurs Res ; 69(4): 254-263, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32205788

RESUMO

BACKGROUND: Building nursing research data repositories with the goal of comparing and synthesizing results across numerous studies and public sharing of data is still in early stages of development. OBJECTIVES: We describe the process of using common data elements (CDEs) to build a data repository for research addressing self-management of chronic conditions. Issues in the development of CDEs, lessons learned in the creation of a combined data set across seven studies of different chronic condition populations, and recommendations for creating and sharing harmonized nursing research data sets are provided. METHODS: In 2014, at initiation of a National Institutes of Health-funded Centers of Excellence in Self-Management Research, our center investigators defined a set of CDEs for use in future center-funded pilot studies consisting of populations having different chronic conditions with the intent to combine the study data sets. Over the next 4 years, center investigators were provided with standardized codebooks and data collection protocols for applying the CDEs and data storage. Data from seven pilot studies were subsequently combined. RESULTS: Although each pilot study was small-with sample sizes ranging from 18 to 31 participants-our combined data set of 179 participants provides us with a sample size sufficient to conduct analyses that could not be done with the individual small samples alone. The research data repository addressing self-management of chronic conditions will soon be available for public sharing. DISCUSSION: Our experience demonstrates that, with careful, upfront planning and ongoing vigilant oversight, CDEs can be applied across studies consisting of different chronic condition populations to combine data sets to create research data repositories for public sharing.


Assuntos
Doença Crônica/terapia , Elementos de Dados Comuns , Pesquisa em Enfermagem/normas , Autogestão , Coleta de Dados/normas , Humanos , Projetos Piloto
20.
J Assoc Inf Sci Technol ; 70(9): 968-980, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31799335

RESUMO

Information behavior may enhance hypertension self-management in African-Americans. The goal of this substudy was to examine relationships between measures of self-reported health information behavior and neural measures of health information processing in a sample of 19 prehypertensive African-Americans (mean age=52.5, 52.6% women). We measured 1) health information seeking, sharing, and use (surveys) and 2) neural activity using functional magnetic resonance imaging (fMRI) to assess response to health information videos. We hypothesized that differential activation (comparison of analytic vs. empathic brain activity when watching a specific type of video) would indicate better function in three, distinct cognitive domains: 1) Analytic Network, 2) Default Mode Network (DMN), and 3) ventromedial prefrontal cortex (vmPFC). Scores on the information sharing measure (but not seeking or use) were positively associated with differential activation in the vmPFC (rs=.53, p=.02) and the DMN (rs=.43, p=.06). Our findings correspond with previous work indicating that activation of the DMN and vmPFC is associated with sharing information to persuade others, and with behavior change. Although health information is commonly conveyed as detached and analytic in nature, our findings suggest that neural processing of socially and emotionally salient health information is more closely associated with health information sharing.

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