Communication strategies for nursing research with older adults diagnosed with schizophrenia using life course theory.

PURPOSE: To explore effective communication strategies that may be used to promote efficacious research with older adults diagnosed with schizophrenia. DESIGN: A theoretical framework of Life Course Theory was used to examine the problems of communicating in research settings with older adults diagnosed with schizophrenia and present potential effective solutions to these problems. METHODS: Using Life Course Theory as an underpinning, a literature review was conducted regarding communication strategies/methods commonly used in psychiatric nursing. This paper deductively presents how these strategies/methods could theoretically improve nursing research with older adults diagnosed with schizophrenia. RESULTS: Four main potential effective strategies for communication with older adults diagnosed with schizophrenia in nursing research were identified which were (1) giving space; (2) shortened intervals; (3) the use of simple, meaningful phrases; and (4) showing engagement. CONCLUSIONS: Older adults diagnosed with schizophrenia may be given more opportunities to share their input regarding their perceptions and valuable input regarding health care systems if these effective strategies of communication are used when conducting nursing research. CLINICAL RELEVANCE: There is a need to gain more information regarding the perceptions of older adults diagnosed with schizophrenia as they are living longer and are entering into a health care system that is often at a quandary as to how to best care for them. The strategies delineated in this paper are part of an ongoing project to co-develop a model with older adults diagnosed with schizophrenia specifically tailored to improve their health outcomes and quality of life.

Exploration of the Influence of Factors Identified in the Literature on School-aged Children's Emotional Responses to Asthma.

Approximately 6.3 million US children suffer from asthma. The purpose of this study was to explore factors on school-aged children's emotional responses to asthma, N=85, ages 6-12. Correlations included Asthma related child emotional functioning QOL and (a) asthma severity, r=-0.30, p<0.01, (b) child internalizing behaviors, r=-0.26, p<0.05, (c) child externalizing behaviors r=-0.43, p<0.001; Caregiver emotional functioning QOL and (a) asthma severity, r=-0.39, p<0.001, (b) child internalizing behaviors, r=-0.22, p<0.05, (c) child externalizing behaviors, r=-0.25; p<0.05. Multiple regression analysis revealed that asthma severity and child externalizing problems accounted for 26% of the variance in asthma related child emotional functioning QOL, F (4, 79)=7.051, p<0.001 (asthma severity, ß=-0.31, p<0.01; child externalizing problem behaviors, ß=-0.43, p<0.001). Findings imply that asthma research should consider problem behaviors of school-aged children when addressing asthma related emotional functioning QOL.

Life Course Perspectives of Aging With Schizophrenia Spectrum Disorders in Psychiatric and Long-Term Care Facilities.

BACKGROUND AND OBJECTIVES: Individuals with schizophrenia spectrum disorders must manage residual symptoms as they age, and they may experience premature or accelerated aging in comparison with those without their diagnosis. To explore their life course perspectives, we interviewed institutionalized adults aging with schizophrenia spectrum disorders in middle and older age. RESEARCH DESIGN AND METHODS: We used an exploratory descriptive design and qualitative methods. Participants answered semistructured, open-ended questions about perceptions of their mental illness along the life course. RESULTS: Participants (N = 30, age 45-83 years) were from an acute care psychiatric facility and a long-term care facility: 16 (53%) men, 14 (47%) women; 6 (20%) Hispanic, 10 (33%) African American, 14 (47%) non-Hispanic White. Participants' life course included traumas from violence, homelessness, and stigma; psychiatric symptoms such as worry and sadness; and age-related physiological symptoms including illness, loss of strength, falls, and incontinence, with falls and incontinence reported only in long-term care. Aging within institutionalization included lack of privacy and autonomy, and isolation (less socialization). Participants provided insights for potential improvements. DISCUSSION AND IMPLICATIONS: Because these aging adults are experts on their own care, researchers should continue to seek their input to inform their healthcare.

Minority caregivers' emotional responses and perceptions of the emotional responses of their children to asthma: comparing boys and girls.

Approximately 7.1 million children in the US suffer from asthma. An exploratory qualitative study using a stratified purposive sampling method was conducted. The sample included four Latina and four African American female caregivers of children (ages 6-12) who had asthma. Caregivers were asked open-ended questions about perceptions of their children's emotional responses to asthma. Major themes and subthemes were identified with content analysis. Sons were reported as quiet when experiencing asthma. Daughters were described as being verbal, worried, excited. A question from the study was whether the children's responses were related to caregivers' (a) actions, (b) responses to asthma, and/or(c) race/ethnicity.

An Online Mindfulness-based Intervention for Certified Nursing Assistants in Long-term Care.

Purpose: Certified nursing assistants (CNAs) make up the largest segment of the long-term care (LTC) setting workforce, however, they are at high risk of job dissatisfaction and burnout. Evidence suggests that mindfulness-based interventions (MBIs) might be particularly relevant and useful for CNAs in reducing psychological distress, improving job satisfaction, and reducing burnout, but little research has investigated this possibility. A feasibility study of an online MBI for CNAs in LTC settings was therefore conducted. Methods: CNAs completed assessments at baseline and posttest. Paired t-tests assessed changes in mindfulness, psychological distress (i.e., depressive and anxiety symptoms, and stress), and professional quality of life. Results: Of the 19 CNAs who started the intervention, N = 13 (68%) completed it and provided postintervention data. Depressive symptoms were significantly decreased postintervention (F = 6.26, p = .036, d = .47). Conclusions: MBIs may have beneficial effects for CNAs in LTC settings. Further research with a larger CNA population will increase the power and relevance of these findings, ultimately contributing to the improvement of patient outcomes in LTC.

Is rural school-aged children's quality of life affected by their responses to asthma?

The unpredictable nature of asthma makes it stressful for children and can affect their quality of life (QOL). An exploratory analysis of 183 rural school-aged children's data was conducted to determine relationships among demographic factors, children's responses to asthma (coping and asthma self-management), and their QOL. Coping frequency, asthma severity, and race/ethnicity significantly predicted children's asthma-related QOL. Children reported more frequent coping as asthma-related QOL worsened (higher scores). Children with more asthma severity had worse asthma-related QOL. Post hoc analyses showed that racial/ethnic minorities reported worse asthma-related QOL scores than did non-Hispanic Whites.

Factors related to emotional responses in school-aged children who have asthma.

A systematic review of the literature was performed to answer the following questions (a) What factors contribute to the emotional responses of school-age children who have asthma? (b) What are the potential gaps in the literature regarding the emotional responses of school-age children (ages 6-12) who have asthma? (c) Are children with a lower socioeconomic status (SES) and those who are minorities represented in the literature proportionate to their prevalence? Two main focus areas regarding emotional responses were identified: (a) factors related to children who have asthma and (b) factors related to caregivers of children who have asthma. Internalizing disorders were reported consistently for children and caregivers of children who have asthma. Negative consequences of asthma for children included panic and asthma attacks, missed school days, and behavioral problems. Issues for caregivers included higher levels of anxiety and depressive symptoms, asthma management deficits, and lower caregiver warmth and involvement. Gaps in the literature included separated studies for children ages 6-12, a lack of a standardized method to define SES, studies that were of a more experimental nature, and a disparate number of studies of minority children and caregivers relative to their asthma prevalence.

Elder's life course theory and person-centered research: A lens for conducting ethical nursing research and mental health nursing practice with older adults aging with the diagnosis of schizophrenia.

INTRODUCTION: Older adults diagnosed with schizophrenia are a vulnerable population owing to the manifestations of their illness, which can include decreased reality orientation, paranoia, hallucinations and delusions. This paper presents ethical principles of vulnerability, veracity, non-maleficence and autonomy for person-centered care in mental health nursing research and practice, focused with the lens of Elder's life course theory (LCT). AIM: To present Elder's LCT as an ethical lens for person-centered care as nurses engage with older adults aging with the diagnosis of schizophrenia in clinical practice and/or research. METHOD: Four ethical principles fundamental to nursing research and mental health practice are presented, with Elder's LCT as a theoretical lens for person-centered care. RESULTS: A model for ethical research and mental health practice with older adults diagnosed with schizophrenia. DISCUSSION: Nursing research and mental health nursing practice with an ethical LCT lens for person-centered can help nurses envision, explore and generate interventions to address the special needs of older adults aging with schizophrenia. IMPLICATIONS FOR PRACTICE: The use of a LCT lens for person-centered care can encourage nurses in research and mental health practice to seek information collaboratively with older adults diagnosed with schizophrenia in a thoughtful, ethical manner, to inform the improvement of their health outcomes and health policy.

The Life Course Paradigm as a Lens for Holistic Nursing Research in Older Adults Diagnosed With Schizophrenia.

Older adults diagnosed with schizophrenia (OADWS) have unique needs for care and live longer today than their forebears who were diagnosed with schizophrenia. As a result, nurses need to be prepared for the specific care of individuals who live with schizophrenia as they age. Together, Life Course Theory and holistic nursing suggest a good fit in the quest for successful solutions and/or outcomes for the unique problems that OADWS face. Holistic nursing views the patient as a whole person, considering all aspects of the patient's experiences within life's broader environment. The life course paradigm offers an effective way for nurses to understand issues that patients face throughout their lives, thus enhancing holistic nursing with a historical perspective. This is especially important for the care of OADWS, who face unique disparities as well as physical and psychological comorbidities over their life course. This article is intended to initiate a discussion of OADWS, focused with Life Course Theory as a holistic lens. Literature pertinent to the life course of OADWS is reviewed, followed by an analysis of the life course paradigm in relation to OADWS' unique experiences. Conclusions support the holistic use of Life Course Theory in research and interventions for OADWS.