The use of change theory to facilitate the consolidation of two diverse Bachelors of Science in Nursing programs.

BACKGROUND: Consolidation of resources, programs, and even universities are measures that university systems consider for economic reasons. The transformation and restructuring of two diverse nursing programs utilized an organizational change tool to guide the consolidation efforts. PURPOSE: Insights on how to use an organizational change model and lessons learned are shared for higher education units that may face consolidation. METHODS: The ADKAR Change Management Model, one of many organizational change resources, was advantageous in consolidating two diverse nursing programs when two universities were mandated to become one. CONCLUSIONS: Change is inevitable yet when faced with transition and transformation, thoughtful and strong, committed leaders who portray open transparent communication are an absolute requirement for sustained change. To guide the process, the ADKAR Change Management Model is an insightful and worthwhile resource.

Sleep loss and its effects on health of family caregivers of individuals with primary malignant brain tumors.

Sleep loss places caregivers at risk for poor health. Understanding correlates of sleep loss and relationships to health may enable improvement of health of caregivers of individuals with primary malignant brain tumors (PMBT). In this cross-sectional, descriptive study of 133 caregivers, relationships were examined between sleep loss and physical, mental, emotional, and social health at time of patient diagnosis. Sleep loss was not related to physical health. Shorter total sleep time was associated with greater fatigue and social support. Sleep quality was positively associated with quality of life. Further study is needed of the role of sleep loss in the PMBT caregiving trajectory and its long-term relationship with health outcomes.

Sleep characteristics of family caregivers of individuals with a primary malignant brain tumor.

PURPOSE/OBJECTIVES: To describe the sleep characteristics of family caregivers of individuals with a primary malignant brain tumor (PMBT). DESIGN: Cross-sectional, correlational design using baseline data from a longitudinal study. SETTING: Neuro-oncology and neurosurgery clinics at an urban tertiary medical center in the United States. SAMPLE: 133 family caregivers recruited one to two months following diagnosis of family member's PMBT. METHODS: Subjective and objective measures of sleep were obtained via self-report and the use of accelerometers (three nights). MAIN RESEARCH VARIABLES: Sleep characteristics including sleep latency, total sleep time, wake after sleep onset, number of naps, number of arousals, sleep-wake cycle, and sleep quality. FINDINGS: Sleep latency in caregivers was, on average, 35 minutes (SD = 34.5)-more than twice as long as the norm of 15 minutes (t[113]) = 6.18, p < 0.01). Caregivers averaged a total sleep time of 5 hours and 57 minutes (SD = 84.6), significantly less than the recommended 7 hours (t[113] = -8, p < 0.01), and were awake in the night 15% of the time, significantly more than the norm of 10% (t[111] = 5.84, p < 0.01). Caregivers aroused an average of 8.3 times during nocturnal sleep (SD = 3.5, range = 2-21), with about 32% reporting poor or very poor sleep quality. CONCLUSIONS: Caregivers experienced sleep impairments that placed them at risk for poor mental and physical health, and may compromise their ability to continue in the caregiving role. IMPLICATIONS FOR NURSING: Nurses need to assess sleep in caregivers of individuals with PMBT and implement interventions to improve sleep. KNOWLEDGE TRANSLATION: Sleep deprivation is common in family caregivers during the early stages of care for individuals with a PMBT. A single-item sleep quality question could be an easy but valuable tool in assessing sleep disturbances in family caregivers of individuals with a PMBT. The health trajectory of family caregivers warrants further longitudinal study, in addition to the examination of the bidirectional relationship of health status of care recipients and their family caregiver.