Cathy Rozmus

Culturally Sensitive Care of the Muslim Patient

The number of Muslims in the United States is growing. This article outlines a few of the major beliefs in Islam. Religious and philosophical factors that affect health care are discussed, and practical suggestions are made for nursing actions that lead to culture care preservation, culture care accommodation, and culture care restructuring. Major topics covered include the need for cleanliness, preparation for prayer, modesty, family structure, fasting and diet, and care of the dying.

Association Between Continuing Education and Job Satisfaction of Nurses Employed in Long-Term Care Facilities

BACKGROUND The purpose of this descriptive, correlational study was to investigate the relationship between continuing education and job satisfaction among RNs and licensed practical nurses (LPNs) employed in long-term care facilities. METHOD Herzbergs Motivational-Hygiene Theory was used as a framework to guide the design of the study. The Professional Educational Activities Scale and the McCloskey/Mueller Satisfaction Scale were completed by 110 nurses employed in long-term care facilities. RESULTS No difference was found between type of employment status (full-time versus part-time) on the level of professional educational activities. However, RNs participated in more continuing education activities than LPNs. Nurses who reported higher family incomes also had greater participation in educational activities. Registered nurses reported greater job satisfaction than LPNs. No significant difference was found between the degree of job satisfaction for Black and White nurses. The results of this study indicated nurses who participated in more continuing education activities scored higher on the job satisfaction scale. CONCLUSION As the elderly population increases, a critical need exists for nurses to be knowledgeable about current research-based information, including the economic and psychosocial effects of illness in later life. To provide the most effective care for the elderly population, nurses in long-term care must be knowledgeable about the complexity and specific characteristics of chronic illnesses. Continuing education activities are an important way to access this information.

Is acanthosis nigricans a reliable indicator for risk of type 2 diabetes in obese children and adolescents? A systematic review.

Obesity and type 2 diabetes is becoming a major health problem affecting children and adolescents in the United States. This article reviews the current literature examining the association between the presence of acanthosis nigricans (AN) and risk for developing type 2 diabetes mellitus (T2DM) in obese children and adolescents. Ethnicity, family history of diabetes, and emergence of obesity are contributing factors for development of hyperinsulinemia, and insulin resistance, and ensuing visible changes on skin which is known as the AN. The purpose of this review was to assess the validity of AN as an early indicator of T2DM. Nineteen articles that were published from 1994 to 2010 were included for this review and reported an association between AN, hyperinsulinemia, and hyperglycemia. Nurses and advanced nurse practitioners working with children and adolescents have a tremendous role in identifying the risk factors, counseling, role modeling, and referring them to available community resources to promote healthy living. Early initiatives focusing on lifestyle changes may halt the progress, chronicity, and burden of T2DM in children and adolescents.

Family strategies for managing childhood cancer: using complementary and alternative medicine in Jordan

AIM This paper is a report of a study that examined the use of complementary and alternative medicine therapies among children with cancer in Jordan. BACKGROUND Complementary and alternative medicine use by oncology patients has been gaining acceptance in the developed countries and developing countries. Healthcare professionals are becoming increasingly aware that patients use complementary and alternative medicine either covertly or overtly. METHODS A descriptive cross-sectional design was used with parents of children with cancer under treatment and follow-up in a paediatric oncology department in Jordan between August 2007 and April 2008. RESULTS Parents of 69 children with cancer in Jordan were surveyed for their use of complementary and alternative medicine with their children. A total of 65.2% of the sample had used at least one type of complementary and alternative medicine during the course of their childs treatment. The use of biological and nutritional complementary and alternative medicine was 70.5% among the users. Use of body and soul complementary and alternative medicine strategies was reported for 22.2% of the children using complementary and alternative medicine. Twenty per cent of the sample used body movement complementary and alternative medicine for their children. A total of 45.5% of complementary and alternative medicine users perceived benefits in using complementary and alternative medicine for their children with cancer. However, 40% of complementary and alternative medicine users had stopped using complementary and alternative medicine for multiple reasons. CONCLUSION Parents used complementary and alternative medicine to support their childrens medical treatment and to use all possible methods to cure their children. The reason for parents not using complementary and alternative medicine included not being aware of complementary and alternative medicine. Most of the patients have not discussed the issue of using complementary and alternative medicine with the medical staff.

The Brewsters: A new resource for interprofessional ethics education

Background: One of the barriers to interprofessional ethics education is a lack of resources that actively engage students in reflection on living an ethical professional life. This project implemented and evaluated an innovative resource for interprofessional ethics education. Objectives: The objective of this project was to create and evaluate an interprofessional learning activity on professionalism, clinical ethics, and research ethics. Design: The Brewsters is a choose-your-own-adventure novel that addresses professionalism, clinical ethics, and research ethics. For the pilot of the book, a pre-test/post-test design was used. Once implemented across campus, a post-test was used to evaluate student learning in addition to a student satisfaction survey. Participants and research context: A total of 755 students in six academic schools in a health science center completed the activity as part of orientation or in coursework. Ethical considerations: The project was approved as exempt by the university’s Committee for the Protection of Human Subjects. Findings: The pilot study with 112 students demonstrated a significant increase in student knowledge. The 755 students who participated in the project had relatively high knowledge scores on the post-test and evaluated the activity positively. Discussion: Students who read The Brewsters scored well on the post-test and had the highest scores on clinical ethics. Clinical ethics scores may indicate issues encountered in mass media. Conclusion: The Brewsters is an innovative resource for teaching interprofessional ethics and professionalism. Further work is needed to determine whether actual and long-term behavior is affected by the activity.

Critical pathways: Application to selected patient outcomes following coronary artery bypass graft

As health care reform evolves in the United States, many hospitals are implementing strategies to contain the cost of coronary artery bypass graft (CABG) surgery. The purpose of this study was to examine the length of stay in the intensive care unit (ICU) after CABG surgery relative to the number of hours, postoperation, when ambulation occurred, and to examine the overall postoperative length of hospital stay. The study found a significant difference between ICU length of stay and the time when ambulation was initiated (t(150) = -2.68; p = .004). These results suggest that CABG patients with shorter ICU stays begin ambulation sooner, thus potentially reducing the risk of postoperative complications as well as cost. No other significant differences were demonstrated.

Biobehavioral Factors in Child Health Outcomes: The Roles of Maternal Stress, Maternal–Child Engagement, Salivary Cortisol, and Salivary Testosterone

BackgroundExposure to high levels of maternal stress and ineffective maternal–child engagement (MC-E) may adversely affect child health-related outcomes. ObjectiveThe aim of this study was to examine the impact of maternal stress and MC-E on maternal and child biological responses (salivary cortisol and testosterone) and child health outcome in mother–child dyads of preschool children (3–5.9 years) in a low socioeconomic setting. MethodsObservational and biobehavioral data were collected from 50 mother–child dyads in a preschool setting. Assessments included maternal stress with the Perceived Stress Scale, child health outcomes with the Pediatric Quality of Life Inventory, and MC-E with videotaped mother–child interactions and scored with the Keys to Interactive Parenting Scale. Morning and evening saliva samples were collected from mother and child for biological assays. ResultsMaternal stress was negatively correlated with MC-E (r = −.32, p < .05) and child health outcome (r = −.33, p < .05). Lower levels of MC-E predicted higher morning cortisol (p = .02) and higher morning and bedtime testosterone levels in children (p = .03 and p = .04, respectively). Child biological responses did not predict child health outcome. DiscussionMaternal stress and MC-E during mother–child interactions play a significant role in the regulation of child stress physiology and child health outcome. Elevated cortisol and testosterone related to high maternal stress and low MC-E may increase the childs vulnerability to negative health outcomes—if sustained. More biobehavioral research is needed to understand how parent–child interactions affect child development and health outcomes in early childhood.

Differences in health-promotion behaviour among the chronically ill in three South Pacific Island countries

In this study, the Health Promoting Lifestyle Profile was used to compare health-promoting behaviours in three groups of chronically ill people being treated as outpatients at clinics and hospitals in Fiji, Nauru, and Kiribati. Significant differences were found between males and females and among groups in relation to practices and attitudes towards health responsibility, physical activity, nutrition, and stress management. Health professionals and educators must develop ways to transmit the message of healthy lifestyles to populations that do not pay much attention to conventional health-education methods.

Rural women’s knowledge of and attitudes toward acquired immune deficiency syndrome

We surveyed the knowledge of and attitudes about acquired immune deficiency syndrome (AIDS) of 236 women living in a rural community. The design of the study was descriptive, using the AIDS Knowledge and Belief Survey. There was a significant positive correlation between attitude scores and knowledge scores. Women who had read about AIDS had significantly higher knowledge scores than women who had not read about AIDS, but there were no significant differences between the attitude scores of women who had and had not read about AIDS.

Ethics and Professionalism Education in a Health Science Center: Assessment Findings from a Mixed Methods Student Survey

BackgroundPrior to initiating interprofessional ethics education, assessment of current student learning of ethics content within their professional schools is essential. Few studies have included direct measures of student learning on ethics and professionalism. This article reports findings from a mixed methods student survey conducted at a comprehensive health science center.PurposeThe purpose of the survey was to explore student self-perception with regard to their knowledge of health professional ethics as well as their ability to analyze self-reported encounters with ethical dilemmas.MethodologyThe survey spanned six health professional schools: a dental school, a graduate school, a medical school, a nursing school, a school of biomedical informatics, and a school of public health. Quantitative data were analyzed using descriptive statistics and ANOVA with Tukey HSD post hoc. Qualitative data were analyzed with a rubric and then qualitative content analysis was conducted to determine common themes.Results and ConclusionsThe findings indicate a need for the continued teaching of ethics and professionalism curricula to health professional students in all schools of this health science center, and qualitative results indicate future topics to be pursued in interprofessional teaching and learning.