Cecilia R. Barron

Nursing Interventions for Spintual Care Preferences of the Community-Based Elderly

This descriptive correlational study examined the relationships between the three concepts of core spiritual experience, spiritual perspective, and self-transcendence, as well as the spiritual-care nursing interventions preferred by a convenience sample of 50 community-based older adults. Results of single-session interviews indicated significant positive correlations among the three concepts. Spiritual interventions preferred by older adults were those interventions focusing on the therapeutic communication skills of the nurse and the nurses attitude and approach toward clients. Overall, older adults who believed in a Higher Power and whose beliefs were prominent in their lifestyle rated spiritual nursing interventions as more important than did older adults who did not hold strong beliefs in a Higher Power and whose spiritual beliefs were not prominent in their lifestyle. Findings give direction for providing spiritual nursing care to older adults.This descriptive correlational study examined the relationships between the three concepts of core spiritual experience, spiritual perspective, and self-transcendence, as well as the spiritual-care nursing interventions preferred by a convenience sample of 50 community-based older adults. Results of single-session interviews indicated significant positive correlations among the three concepts. Spiritual interventions preferred by older adults were those interventions focusing on the therapeutic communication skills of the nurse and the nurses attitude and approach toward clients. Overall, older adults who believed in a Higher Power and whose beliefs were prominent in their lifestyle rated spiritual nursing interventions as more important than did older adults who did not hold strong beliefs in a Higher Power and whose spiritual beliefs were not prominent in their lifestyle. Findings give direction for providing spiritual nursing care to older adults.

Pain perception and its relation to functional status post total knee arthroplasty: a pilot study.

PURPOSE This pilot study examined the influence of pain perception on functional status. DESIGN A descriptive longitudinal correlational exploratory design was used. SAMPLE The sample comprised 23 participants ranging in age from 47 to 85 years. RESULTS Data were collected for pain perception components, anxiety, and functional status. Negative correlations were noted between pain and functional status on days 42 and 84. Common descriptors used over the first 3 days were sharp, aching, tender, and tiring. CONCLUSIONS Pain intensity is only one component of pain perception. Management of the sensory and affective components needs further research.

Loneliness in Low-Vision Older Women

The purpose of this analysis was to identify predictors of loneliness in women 75 years of age and older with low vision. The sample of 56 women was derived from a larger study of low-vision adults. Womens loneliness, optimism, social support, living arrangement, vision, and perceived health were examined using the revised University of California, Los Angeles, Loneliness Scale, the Life Orientation Test, the Social Support Questionnaire, and a demographic questionnaire. Data were analyzed using descriptive statistics, Pearson correlations, multiple regressions, and t-tests. Optimism and social support satisfaction were found to predict degree of loneliness in the sample. Women who were less optimistic and less satisfied with their social support system experienced higher levels of loneliness. Duration of visual impairment was associated with duration of loneliness. The findings provide nurses with information for identifying low-vision older women who are at risk for loneliness.

Low-Vision Elders: LIVING ARRANGEMENTS, LONELINESS, AND SOCIAL SUPPORT

1. Loneliness was not found to be a significant problem in a study of low-vision older clients with various living arrangements. Different types of support networks did serve different functions depending on whether clients lived alone or with others. 2. Clients living alone were more satisfied with supporters who helped them when they were feeling down, whereas clients living with others were more satisfied with supporters who cared about them. 3. Clients living alone relied on friends and children as the most important sources of support; clients living with others relied most on children for the majority of their needs. 4. Supportive expectations should be shared with supporters in the network to prevent burnout of the support person and lack of support for the client in crises if the supportive person is not available.

A review of instruments measuring two aspects of meaning: search for meaning and meaning in illness

AIM This paper is a report of narrative review of psychosocial instruments measuring two aspects of meaning: the search for meaning and meaning in illness. BACKGROUND Studies have shown that meaning has significance for well-being, particularly for those experiencing illness/negative events. Understanding a persons ascription of meaning to a stressful event can facilitate planning of supportive nursing interventions. METHOD A literature search was conducted using Medline, PsycInfo, PsycArticles, CINAHL, ProQuest, Ebsco and MasterFile Premier for the period 1956-2006. The search terms were: meaning instruments, search for meaning, meaning in illness, significance of meaning and positive meaning. Only studies that employed measurement of one of these two aspects of meaning were included. FINDINGS Twelve instruments were retrieved from the search. Five were measures of search for meaning and seven were measures of meaning in illness. With a few exceptions these instruments were conceptually and operationally congruent and had acceptable psychometric properties. Limiting factors were the infrequent use of some of the instruments clinically or in research, and lack of evidence that cultural or age-specific factors had been considered in the development of the instruments. CONCLUSION Progress with research into meaning and clinical use of meaning instruments may be augmented by refinement of instruments in the areas of conceptual clarity, operational congruence, psychometric properties and cultural and age-specific considerations. Good quantitative assessment will facilitate analysis of the relationship between ascriptions of meaning and psychosocial functioning, and lead to improved nursing interventions.

Coping Style and Women's Participation in Breast and Gynecological Screening

Abstract The purpose of this project was to determine the role of coping style in womens practice of breast and gynecological screening behaviors. Women were classified into one of four coping groups based on measures of vigilance and screening distress. Data were analyzed from a subset of 85 U.S. women who participated in a larger longitudinal study designed to examine self-reported screening participation. Results indicate frequency of screening participation and importance of obtaining immediate mammography feedback differed across coping style groups. Women characterized as high in vigilance and screening distress were most at risk for nonparticipation in screening.

The First Anniversary: Stress, Well-Being, and Optimism in Older Widows

The first anniversary for older widows (n = 47) has been explored during Months 11, 12, and 13. Concurrent correlations show that optimism inversely correlates with psychological (intrusion and avoidance) stress as measured with the Impact of Event Scale (r = —.52 to —.66, p < .005) and positively correlates with well-being (physical: r = .36 to .46, p < .025; psychosocial: r = .58 to .72, p < .005; spiritual: r = .50 to .69, p < .005). Lagged correlation patterns suggest that higher levels of optimism at a given time are associated with higher life satisfaction and spiritual well-being at later times. Psychological stress is higher at Month 12 when compared to Month 13, t(43) = 2.54, p = .01, but not when compared to Month 11, t(43) = 1.49, p > .10. There are no significant differences in physiologic stress (salivary cortisol) or well-being during the first anniversary of spousal bereavement.

Spousal Bereavement Assessment: A Review of Bereavement-Specific Measures

The death of a spouse represents a common form of bereavement among adults and is associated with significant distress and adaptation. This 10-year review of the bereavement literature highlights 12 tools used to assess bereavement in spousally bereaved samples. Pertinent measurement foci and psychometric properties of each tool are presented. Applicability of each tool within the spousal bereavement process is discussed, and aspects of the spousal bereavement process not currently addressed or under-addressed provide direction for future tool development.

Meaning in heart disease: measuring the search for meaning.

The purpose of this study was to test the psychometric properties of a new measure, the Meaning in Heart Disease instrument (MHD), in persons who underwent percutaneous coronary intervention (PCI). Within 1 year of PCI, 232 persons completed the MHD and construct validity measures (SF-36v2™, Hospital Anxiety and Depression Scale). Study aims were examined using reliability analysis, factor analysis, and correlations. After factor analysis, four scales reflecting the theoretical concepts central to the conceptual framework of the instrument emerged—Disrupted Meaning (α = .93), Refocusing Global Meaning (α = .92), Searching for Answers (α = .82), and Ignoring Heart Disease (α = .77). Convergent and divergent validity was supported, in part, for all scales. The MHD had strong support for its validity and will be useful in testing nursing interventions aimed at helping individuals integrate heart disease into the life experience.

A Concept Analysis of Resilience Integrating Genetics

ABSTRACT Although clinicians and researchers are interested in the phenomenon of resilience, there is no agreed-upon definition of resilience. Scientific evidence suggests that resilience is influenced by intrapersonal (e.g. personality traits) and environmental (e.g. social support) variables. A concept analysis was conducted to better understand the meaning of resilience. In this analysis, the antecedent of resilience was a potentially traumatic event; the defining attributes were ego-resiliency, emotion regulation, social support, and heredity; and the consequences were none to mild psychopathological symptoms and positive adaptation. This analysis can help nurses better understand resilience and its relationships to both intrapersonal and environmental variables.