Influence of social support on asthma self-management in adolescents.

OBJECTIVE: Adolescents with asthma are influenced by peers and family. The objective was to better understand family social support and test its association with medication adherence, asthma control, and Emergency Department (ED) use. METHODS: This study is a cross-sectional secondary data analysis from a randomized controlled trial with urban adolescents from three U.S. cities. Participants (12-20 years old) with asthma completed the Perceived Family Support Scale (PFS) and Horne's Medication Adherence Report Scale (MARS). Data from both tools were classified into 2 categories- high and low (< 25th percentile) perceived family support and high (total score >10) and low medication adherence, respectively. Chi-square statistic and logistic regression were used for analysis. RESULTS: Of the 371 participants, the majority were young (96% ≤ 17 years), African American or Bi-racial (85%), and Medicaid-insured (72%); over one-third had maternal family history of asthma. Among those on a controller medication (n = 270), only 37% reported its use ≥8 days over 2 weeks. Asthma control was poor with 50% categorized "not well controlled," 34% "very poorly controlled." Participants responded positively to most social support items. One item, providing and receiving social support to and from family members, was less often positively reported. Low medication adherence was significantly associated with lower perceived social support (p = 0.018). CONCLUSION: This study underscores the importance of family social support in understanding the extent of adolescents' self-management, particularly medication adherence.

An Interprofessional Virtual Healthcare Neighborhood: Effect on Self-Efficacy and Sleep Among Caregivers of Older Adults With Dementia.

An Interprofessional Virtual Healthcare Neighborhood (VHN) was designed to deliver information, peer support, and professional guidance to caregivers of individuals with dementia. The VHN was also enhanced with an actigraphy band to monitor caregivers' sleep. The study sample comprised two groups (N = 28): caregivers participating in the VHN and those receiving usual care. Measures of sleep quality and quantity, using an actigraphy band; general self-efficacy, using the General Self-Efficacy Scale; and insomnia, using the Insomnia Severity Index, were measured pre- and postintervention for the intervention and comparison groups. Neither group reported significant changes in sleep quality or quantity over time. Insomnia severity decreased for both groups. Self-efficacy became worse for the comparison group, yet remained virtually unchanged for the intervention group. Overall, the current study also showed an effective use of technology to reach homebound caregivers of older adults with dementia. [Journal of Gerontological Nursing, 42(11), 39-47.].

Recruitment of older African American males for depression research: lessons learned.

Depression is projected to become the leading cause of disability and the second leading contributor to the global burden of disease in approximately 10years. Few studies have explored the signs and symptoms of depression experienced by older African American men. Therefore, a pilot study was developed with the goal of addressing this gap in knowledge. Despite a variety of recruitment strategies, the study yielded no participants after 9months of effort. Lessons learned from the recruitment efforts and other researchers' successful techniques and strategies are discussed.

Measures and Influencers of Reintegration for the Stroke Patient: A Systematic Review.

ABSTRACT: BACKGROUND: Stroke survivors may experience continued difficulties with reintegration, including challenges participating in social roles and performing activities of daily living across settings (eg, home, work). This article assessed the reintegration measures currently used in this clinical population, defining factors that most influence reintegration for these persons. METHODS: A systematic review of PubMed, Scopus, and the Cumulative Index to Nursing and Allied Health Literature databases explored reintegration measures and factors influencing reintegration in stroke populations. Study inclusion criteria for this review were as follows: data-based articles (quantitative and qualitative), studies measuring reintegration or examining outcomes of reintegration, participants being adult stroke populations, and studies published in English. The resulting articles were critically analyzed, and common themes regarding barriers, facilitators, and influencers of reintegration were established. RESULTS: A total of 24 articles met the inclusion criteria and were synthesized for use in this systematic review. Across stroke populations, 13 reintegration tools were used. A few factors, including residual stroke impairments, unmet needs, social support, and sociodemographic characteristics, are currently known to influence reintegration for this population. CONCLUSION: Reintegration must be uniformly defined and measured to best support stroke survivors, and further investigation into influential factors is critical to advance this goal. This review defines current assessments and factors influencing reintegration within stroke populations. Achieving these goals is critical to optimizing reintegration efforts and designing quality-of-life-improving nursing interventions for affected persons.

Religiosity, self-efficacy for exercise, and African American women.

Physical inactivity among African American women persists despite health promotion efforts targeting this population. In the African American faith community, thinking patterns related to personal versus divine control over health status could affect self-efficacy beliefs and physical activity behavior. Religiosity, a determinate of self-efficacy for exercise, is influenced by culture. This exploratory pilot study assessed the psychometric properties and relevance of selected study instruments and relationships among the study variables in African American women recruited through a rural church. Findings indicated a trend toward significance among study variables and that the God Locus of Health Control and Physical Exercise Self-Efficacy Scales were reliable for capturing attitudes about ability to engage in physical activity and religiosity in this sample. Six of the twenty-five women recruited failed to complete the Stanford Brief Activity Survey for Work and Leisure Time Activity correctly, suggesting the need to revise instructions prior to future instrument administration.

Predictors of mental health, subjective burden, and rewards in family caregivers of patients with chronic liver disease.

Patients with chronic liver disease (CLD) often experience severe symptoms that cause functional impairment and necessitate assistance from a family caregiver. Few studies investigate family caregivers of patients with CLD. This descriptive correlation study described demographic characteristics, depressive and anxiety symptom levels, and prevalence of hazardous drinking, rewards, and subjective burden and explicated predictors of subjective burden and mental health status for a convenience sample of 73 family caregivers of persons with CLD. Interventions are needed to offset decreased income reported by caregivers and to treat depressive symptoms; clinically significant levels were present, and clinical referrals were warranted in this study sample.

The clinical utility of the Stress Process Model in family caregivers of liver transplant candidates.

This article describes the important relationship between theory and practice and demonstrates the application of Pearlin and colleagues' Stress Process Model to family caregivers of liver transplant candidates. Theory enhances the use of specific nursing interventions. This connection of theory to practice is especially important in the current health care environment, where the nursing shortage demands efficient and effective patient care. The Stress Process Model is a specific and concrete middle-range theory, which makes it simple to apply in clinical practice and research. This model is particularly useful for nurses who support the family caregivers of clients on the liver transplant list. The model identifies characteristics that predispose caregivers to stress that can interfere with completion of caregiving roles and tasks before and after patients' liver transplantation.

Measuring Health-Related Quality of Life of Adults With Down Syndrome.

This study examined self- and caregiver-reported health-related quality of life (HRQOL) of 60 adults with Down syndrome (DS) using the QualityMetric Short Form-12 version 2 (SF-12v2). All HRQOL scores exceeded means and fell within one standard deviation of the SF-12v2 normative sample. Similarities between eight self- and caregiver-reported HRQOL scales were found with the exception of role physical scores (impact of health problems on typical accomplishments), which were lower when obtained by caregiver-report. A positive association was found between self- and caregiver-reported physical functioning scores (impact of health problems on physical activity). The SF-12v2 had high construct validity in this study. These findings support the feasibility of measuring HRQOL of adults with DS using self-report rather than reliance on caregiver-report.

Promoting Success of Ethnic Minority and Male Students in an Accelerated, Entry-Level Master of Nursing Program: The SUSTAIN Program.

BACKGROUND: Diverse health care workers are essential to meet the needs of a diverse U.S. POPULATION: Ethnic minorities and men are frequently underrepresented in the nursing profession and within schools of nursing. Although many nursing schools have implemented programs to improve retention and academic success of these students, the lack of success is, in part, a reflection of program ineffectiveness. METHOD: A nursing college developed the multifaceted SUSTAIN (Scholarships for Underrepresented Students in an Accelerated Initial Nursing) program to promote ethnic minority and male students' success in an accelerated entry-level master of nursing program. Students engaged in mentoring, academic support, and service-learning activities. RESULTS: Participants (N = 51) achieved 100% retention and graduation rates and a 92% first-time NCLEX-RN(®) examination pass rate. Program students participated in professional organizations and held leadership roles within the college. CONCLUSION: Implementation of a program focused on student retention and success is recommended for diverse students enrolled in accelerated entry-level master of nursing programs.

Length of stay, admission types, psychiatric diagnoses, and the implications of stigma in African Americans in the nationwide inpatient sample.

African Americans purportedly have a higher prevalence of mental illnesses but are often misdiagnosed and less likely to seek treatment. Delayed treatment has been associated with the stigma related to these disorders. The demographic characteristics, length of stay, most prevalent psychiatric diagnoses, and hospital admissions of African Americans were compared to other U.S. populations using a nationwide sample (N = 4,474,732). African American participants were younger, had significantly longer lengths of stay, and were admitted more often through the emergency room than the other groups in this sample. Psychosis, alcohol/drug dependence, and depressive neurosis were the most prevalent psychiatric diagnoses reported for African American participants. Research is needed to explain these results so that strategies can be instituted to improve the poor mental health outcomes often observed in African American populations.