Carrie Jo Braden

Finding meaning: antecedents of uncertainty in illness.

In this study a portion of the uncertainty in illness model was tested. Antecedents to uncertainty tested were the stimuli frame variables of symptom pattern and event familiarity and the structure provider variables of education, social support, and credible authority. Data were collected on a convenience sample of 61 women with gynecological cancer at the time of major treatment effect. Findings supported the proposed model with an empirically generated revised model presenting the influence of antecedents on specific areas of uncertainty. Divergent paths for reducing uncertainty were found. Social support, credible authority, and event familiarity had the greatest influence on lowering the level of uncertainty. Event familiarity and credible authority were primarily effective in reducing the complexity surrounding treatment and the system of care. Social support functioned to decrease the level of ambiguity concerning the state of the illness. Findings generally support the proposed explanation for uncertainty arousal and have substantive significance in identifying the sources of stimuli leading to uncertainty arousal and modification.

A test of the Self-Help Model: Learned response to chronic illness experience

The purpose of this study was to increase understanding of the essential dynamics of learned response to chronic illness experience. A Self-Help Model was tested with 396 subjects with diagnoses of rheumatoid arthritis or arthritis-related conditions. Self-Help Model variables include disease characteristics, background inputs, monitoring, severity of illness, dependency, uncertainty, enabling skill, self-help, and life quality. Severity of illness, disease characteristics, background inputs, and monitoring explained 24% of the variance in dependency and 40% of the variance in uncertainty. Monitoring was the strongest contributor to explanation of enabling skill; however, only a small amount of the variance in enabling skill was explained, adjusted R2 = .15. Enabling skill was the strongest predictor of self-help, β = .42, minimizing the influence of uncertainty, β = -.23 and dependency, β = -.10, on self-help, R2 = .55. Self-help was strongly related to life quality, β = .62. Self-help and uncertainty explained 49% of the variance in life quality. Results suggest a basis for interventions that reduce dependency and uncertainty and enhance enabling skill.

Design, evaluation, and translation of nursing interventions

Nurse-led intervention research is a core component of the global initiative to improve quality of care. Though research in this area has already contributed much to the advancement of patient care, future strides depend on the dissemination of practical, how-to instruction on this important area of research. Design, Evaluation, and Translation of Nursing Interventions aids in this endeavour by presenting both general approaches and specific methods for developing nursing interventions. Logically organized to facilitate ease of use, the book is divided into four sections. The introduction provides a firm grounding in intervention science by situating it within the broader topics of evidence-based practice, client-centred care, and quality of care. Section Two describes each step of intervention design, including correct identification of the health issue or problem, clarification of the elements comprising an intervention, and application of theory. Section Three is centred on implementation, highlighting such topics as development of the intervention manual, training interventionists, and intervention fidelity. The book concludes with methods to evaluate interventions enacted and suggestions for their translation into practice.

Specific Psychosocial and Behavioral Outcomes from the Systemic Lupus Erythematosus Self-Help Course

This study tested hypotheses about the consistency of specified outcomes with strength of program treatment indexed by time spent in a given activity in the Systemic Lupus Erythematosus Self-Help (SLESH) course. Participants had significant increases in enabling skills and in use of relaxation and exercise activities. Participants also had significantly less depression. Consistency between amount of time spent in class and significant changes over time was demonstrated by analysis of treatment strength-response for perception of limitations, depression, enabling skill and for use of rest, relaxation, heat, and exercise activities.

Depression Burden, Self-Help Interventions, and Social Support in Women Receiving Treatment for Breast Cancer

Abstract The purpose of this article is to describe the interaction effects of depression burden (depressive symptoms experienced as a burdensome side effect) with a set of oncology support interventions on social support for women receiving treatment for breast cancer. A repeated measures design was used with measurement occurring at three points in time: T1 (baseline after adjuvant medical treatment was initiated), T2 (six to eight weeks after T1) and T3 (three months after T2). Two hundred forty-seven women were randomly assigned to treatment (n = 194) or control (n = 53). The treatment group consisted of women participating in three different, but complimentary self-help interventions. Depression burden, even at low levels, influenced the critical dimensions of social support structure, function, and nature.

Community and scholars unifying for recovery

A convergence of events led to a remarkable partnership. It began in 2001 when The University of Texas Health Science Center at San Antonio School of Nursing (UTHSCSA-SON) demonstrated its dedication to developing young researchers by creating a Research Scholars seminar. This seminar is held Fridays at noon at the School of Nursing with research scholars and research faculty joining in discussions, presentations, and instruction in current research projects, themes, and conference preparation. In its fourth year, this seminar became a learning environment for Community-Based Participatory Research (CBPR) and Student Service-Learning. The purpose of this paper is to share with you the steps we took on this journey in creating a project partnership among the Research Scholars and the Prosumer Group. It is our hope to provide an example of a successful partnership that began with a foundation built on mutual respect, trust, integrity, and honesty. In 2005, the School of Nursing opened its doors to the Prosumer Group, a group of people diagnosed with psychiatric disorders that are proactive in their recovery and are giving back to their community. The

Side effects burden in women with breast cancer.

PURPOSE This article describes the side effects burden of 307 women who were receiving treatment for breast cancer. The study provides a description of the impact of side effects burden on adult role activities (self-help), self-care, psychological adjustment, and quality of life. DESCRIPTION OF STUDY Data to describe the side effects burden characteristics of 307 women receiving treatment for breast cancer were drawn from the Self-Help Intervention Project. Data were collected after medical treatment was underway and treatment-related side effects were evidenced. The impact of side effects burden on adult role activities (self-help), self-care, psychological adjustment, and life quality is described. RESULTS Fatigue was the most common side effect as well as the most problematic. Number of side effects and increase in side effects were moderately correlated (P < 0.0001) in a negative direction with fatigue and depression. Self-care behaviors also were associated negatively with the extension of side effects and with fatigue and depression (P < 0.001). Psychological adjustment was associated with difficulty sleeping, anxiety, and depression. Overall life quality was noted to be negatively related to depression as was present life quality. CLINICAL IMPLICATIONS Data support the need for clinical interventions that are individualized to womens side effects experience. Additional research is underway to test the effectiveness of the interventions specified by the overall study.

Encouraging client self-discovery.

Four facets of community health nursing behavior help clients to develop their self-reliance.