Cynthia Teel

Fatigue among Elders in Caregiving and Noncaregiving Roles

Fatigue is a complex symptom prevalent in informal caregiving. When role demands exceed caregiver resources, fatigue ensues and caregiving can be compromised. The purpose of this study was to compare perceptions of fatigue among older adults (N = 92) caring for spouses with Alzheimer’s disease, Parkinson’s disease, or cancer with a control group of older adults (N = 33) whose spouses required no extra care. Caregiving elders reported more fatigue, less energy, and more sleep difficulty than did control participants. All caregiving groups reported similar levels of fatigue, energy, sleep, and self-reported health even though there were marked differences regarding spousal status. Health care providers can support older caregivers in monitoring their own health and in recognizing the need for services that support the caregiving role.

Comparing Old and Young Adults as They Cope with Life Transitions: The Links between Social Network Management Skills and Attachment Style to Depression

Smaller social networks are associated with poorer health and well-being, especially as people negotiate life transitions. Many older adults, however, tend to have smaller networks, without the expected negative outcomes. To understand better how older adults avoid such outcomes we measured social network management skills, attachment style, and depression among individuals going through a life transition. Older adults who recently became caregivers were compared with young adults who recently transitioned to college. Although older adults initiated fewer and terminated more social ties (being selective in their choice of network members), both age groups had an equal number of close network members. A closer look revealed that securely attached older adults maintained their social ties, and in turn, sustained low levels of depression. These findings emphasize the importance of attachment style and network skills to mental health in general, and among older adults specifically.

Common themes in clinical education partnerships.

The concurrent nursing and faculty shortages continue to be critical issues for the nations health care system. As academic nursing programs struggle with maintaining and increasing enrollment in the midst of a faculty shortage, one solution is to expand the facultys capacity through innovative academic-service partnerships. Schools and clinical partners identified as having implemented innovative partnerships were invited to participate in this descriptive study. Site visitations to schools in Florida and Texas were conducted to gain in-depth knowledge of the clinical education model, the academic-service partnership, and the strengths and challenges associated with planning, implementing, and sustaining programs. Four underlying features were common across the successful implementation: supportive relationships, goodness of fit, flexibility, and communication. Consideration of the four features will be useful as nursing programs and their clinical partners are developing, implementing, and evaluating new models for increasing educational capacity and lessening the nursing shortage.

Beyond Correspondence, Video Conferencing, and Voice Mail: Internet-Based Master's Degree Courses in Nursing

The changing health care system and increasing demands for primary care providers have prompted an increase in nurse practitioner programs in the United States. Nurses in rural areas that are underserved by primary care practitioners often are faced with time and distance barriers to returning to school for advanced education. This article describes Internet-based courses as a unique distance learning platform for preparing primary care nurse practitioners at the University of Kansas (KU) School of Nursing. Discussion includes course development process, matching methods to course content, and other information on promoting interaction between students and faculty.

Infected Lives Lived Experiences of Young African American HIV-Positive Women

This hermeneutic phenomenological study explored the lived experiences of young African American HIV-infected women. Eleven women between the ages of 21 and 35 participated. One pattern, Infected Lives, and three themes—Living Alone With HIV, Living With Unresolved Conflicts, and Living With Multiple Layers of Betrayal—emerged. The pattern and themes portray the very complex and challenging experiences faced by these young women living with HIV infection. They have experienced isolation, abandonment, betrayal, and discrimination in their interpersonal and social systems. They often dealt with conflicts of hope and anguish in the relationships with their children, and portraying strength, while feeling fragile. These complexities negatively influence the ability to fully engage in self-care activities. Implications for future research include further investigation about the experiences of psychological distress experienced post-diagnosis, development and evaluation of holistic nursing interventions, and evaluative research on mass media educational campaigns to reduce HIV-related stigma.

Exploring leadership roles, goals, and barriers among Kansas registered nurses: A descriptive cross-sectional study

OBJECTIVES The Institute of Medicines Future of Nursing report advocates for full nurse leader representation across multiple settings to address current challenges in our health care system. The purpose of this study was to examine nursing leadership development needs among Kansas registered nurses (RNs). METHODS Data were collected through an online survey and analyzed using quantitative and qualitative methods. RESULTS Nearly 1,000 Kansas RNs participated. Most reported holding one or more leadership positions. Prevalent leadership goals were health care organization volunteer administrative roles. The most frequently identified barrier to developing leadership roles was time constraints. Many wanted to develop skills to serve on a board, 20% were interested in personal leadership development, and 19% in policy development. CONCLUSIONS Based on the findings, the Kansas Action Coalition leadership team is developing programs to address the leadership needs of Kansas RNs. By building capacity in advanced leadership roles, RNs will be better prepared serve as full partners and lead efforts to promote the health of Kansans.

Fatigue in Type 2 Diabetes: Impact on Quality of Life and Predictors

Fatigue is a persistent symptom, impacting quality of life (QoL) and functional status in people with type 2 diabetes, yet the symptom of fatigue has not been fully explored. The purpose of this study was to explore the relationship between fatigue, QoL functional status and to investigate the predictors of fatigue. These possible predictors included body mass index (BMI), Hemoglobin A1C (HbA1C), sleep quality, pain, number of complications from diabetes, years since diagnosis and depression. Forty-eight individuals with type 2 diabetes (22 females, 26 males; 59.66±7.24 years of age; 10.45 ±7.38 years since diagnosis) participated in the study. Fatigue was assessed by using Multidimensional Fatigue Inventory (MFI-20). Other outcomes included: QoL (Audit of Diabetes Dependent QoL), and functional status (6 minute walk test), BMI, HbA1c, sleep (Pittsburg sleep quality index, PSQI), pain (Visual Analog Scale), number of complications, years since diagnosis, and depression (Beck’s depression Inventory-2). The Pearson correlation analysis followed by multivariable linear regression model was used. Fatigue was negatively related to quality of life and functional status. Multivariable linear regression analysis revealed sleep, pain and BMI as the independent predictors of fatigue signaling the presence of physiological (sleep, pain, BMI) phenomenon that could undermine health outcomes.

Strategies for Building Advocacy Skills Among Undergraduate and Graduate Nursing Students.

BACKGROUND Nursing faculty are challenged to create learning experiences that both reflect the complexities of the current health care system and are relevant. Experiential learning opportunities should promote engagement in health care that extends beyond direct patient care to advocacy in larger systems. METHOD To meet this challenge, faculty developed course assignments for students at baccalaureate, masters, and doctoral levels in which students worked with state Action Coalitions to implement the Institute of Medicine Future of Nursing reports eight recommendations. With faculty guidance, student teams developed and implemented projects or conducted research to assist the coalitions in their grassroots initiatives. RESULTS Students at all program levels reported high levels of satisfaction and engagement with these unique projects. Students reported understanding the importance of the Future of Nursing recommendations and intended to continue participating in statewide initiatives. CONCLUSION Experiential learning opportunities at all program levels can engage students in learning more about advocacy, health care trends, and leadership.

Patient perspectives about bariatric surgery unveil experiences, education, satisfaction, and recommendations for improvement

BACKGROUND Following bariatric surgery, up to 35% of patients struggle with strict regimens and experience weight recidivism within 2 years [1-5]. Accredited weight management centers (WMC) must provide educational programs and support patients in lifestyle changes before and after surgery. Educational programs, however, may not be evidence-based or patient-centered and may vary in curriculum, approach, and educator type [6]. OBJECTIVE To obtain patient descriptions about the weight loss surgery (WLS) experience, including education, satisfaction, and recommendations for improvement. SETTING Participants were recruited from a university hospital-based WMC in Pennsylvania. METHODS This qualitative descriptive study used purposive sampling and inductive content analysis. RESULTS A NEW ME-VERSION 2.0, encompassed themes from semistructured interviews with 11 participants (36% male). Theme 1: Programming and Tools, explained how individuals undergoing WLS found support through educational programming. Theme 2: Updates and Upgrades, identified issues surrounding quality of life and challenges before and after surgery. Theme 3: Lessons Learned and Future Considerations, identified satisfaction levels and recommendations for improving the WLS experience. Participants reported positive experiences, acknowledging educational programs and extensive WMC resources, yet also offered recommendations for improving educational programming. CONCLUSION Patient narratives provided evidence about the WLS experience. Achievement of weight goals, adherence to rules, and improved health status contributed to perceptions of WLS success. Participants encouraged educators to identify expected outcomes of educational programming, monitor holistic transformations, foster peer support, and use technology in WMC programming. Results also validated the need for the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Programs education requirement (standard 5.1). Future educational research could help develop best practices in WLS patient education and assess associations between education and clinical outcomes.

The development of a comprehensive community health center in a rural community: A qualitative case study

Purpose – This paper seeks to identify strategies that promote the development and sustainability of a successful comprehensive community health center located in a rural Mid‐western state.Design/methodology/approach – The authors used a qualitative case study methodology, using a purposive sample of 15 employees and board members of a rural community health center. Semi‐structured interviews were conducted, transcribed, and analyzed for common themes and sub‐themes that would describe the strategies used to develop and sustain the successful center.Findings – Leading with Consideration was identified as the dominant theme in the interviews, field notes and archival data. Four sub‐themes: Living the Mission, Fostering Individual Growth, Building a Community, and Encouraging Innovation, emerged from the narratives. Leadership was the most important theme that emerged from the data, resulting in a workforce culture that upholds the mission of the center, leadership that seeks to inspire the growth of both e...