Debra C. Wallace

Reported stressors and ways of coping utilized by intensive care unit nurses

Registered nurses within the intensive care unit work within a fast-paced, highly technologic setting, caring for patients with complex needs. The purpose of this investigation was to identify stressors intensive care unit nurses perceived as most prevalent within their work setting, and the types of coping utilized by nurses in this setting. The research design was a descriptive method that utilized a survey among a convenience sample of nurses, employed within the intensive care unit setting at 7 acute care metropolitan hospitals. The quest is to foster effective coping mechanisms and reduce stress to increase staff retention, increasing job value, while increasing quality of patient care and safety.

Spirituality and Spiritual Care Provided by Parish Nurses

The high level of religious participation in the United States provides a venue for parish nursing, a holistic nursing specialty that emphasizes the relationship between spirituality and health. This descriptive study measured two aspects of spirituality (spiritual perspective and spiritual well-being) in a national sample of parish nurses and described variables related to their practice. Furthermore, it qualitatively examined the provision of spiritual care to clients in this parish nurse sample. Parish nurses scored high in spiritual perspective and spiritual well-being and reported an emphasis on health promotion and education in their activities. Three views of spiritual interventions (ideal, general, and specific) were reported. Types of spiritual interventions typically fell into one of four categories: religious, interactional, relational, and professional.

Perceptions of Barriers in Managing Diabetes Perspectives of Hispanic Immigrant Patients and Family Members

Purpose Hispanics show poorer self-management of type 2 diabetes than non-Hispanic whites. Although previous studies have reported socioeconomic and cultural barriers to diabetes self-management by Hispanics, little is known about perceived barriers to diabetes self-management from the perspectives of both Hispanics and their family members. The purpose of the study was to explore perceived barriers among Hispanic immigrants with diabetes and their family members. Methods A qualitative study using 5 focus groups was conducted. A total of 73 Hispanic immigrants with type 2 diabetes (n = 36) and family members (n = 37) were recruited in the southeastern United States for a family-based intervention study of diabetes-self management. Participants were asked to describe their perceptions of barriers to self-management. The 5 sessions were audiotaped and transcribed, translated from Spanish into English, and analyzed using standard content analysis. Demographics, hemoglobin A1C levels, blood pressure, and body mass index (BMI) were obtained both for participants with diabetes and for their family members. Results Barriers to diabetes self-management identified by participants with diabetes were in 3 major themes categorized as: suffering from diabetes, difficulties in managing the disease, and lack of resources/support. Two key themes emerged pertaining to family members: we can provide support and we lack knowledge. Conclusions Perceived barriers to diabetes self-management described by Hispanic immigrants with diabetes and family members indicate a lack of intervention strategies to meet their needs. Interventions should include culturally relevant resources, family support, and diabetes self-management skills education.

A Family-Based Diabetes Intervention for Hispanic Adults and Their Family Members

Aims The purpose of this quasi-experimental, 1-group longitudinal study is to examine the effects of a family-based intervention program on diabetes self-management behaviors, A1C, other biomarkers, psychosocial factors, and health-related quality of life in Hispanics with diabetes. Methods Adult patients with diabetes (n = 36) and family members (n = 37) were recruited from a community clinic in rural central North Carolina. Patients and family members attended an 8-week culturally tailored diabetes educational program taught in Spanish. Data were collected pre- and post-intervention for both patients and family members, with an additional data collection for patients 1 month post-intervention. Results Most patients and family members were female, and almost all were immigrants. A1C decreased by 4.9% on average among patients from pre-intervention to 1 month post-intervention. Patients showed significant improvements in systolic blood pressure, diabetes self-efficacy, diabetes knowledge, and physical and mental components of health-related quality of life. Higher levels of intake of healthy foods and performance of blood glucose tests and foot inspections were reported. Family members significantly lowered body mass index and improved diabetes knowledge from pre-intervention to immediately post-intervention. No significant changes in levels of physical activity were found among patients with diabetes or family members. Conclusions Findings suggest that including family members in educational interventions may provide emotional and psychological support to patients with diabetes, help to develop healthy family behaviors, and promote diabetes self-management.

Physical Activity, Obesity, Nutritional Health and Quality of Life in Low-Income Hispanic Adults With Diabetes

The study examined relationships among age, body mass index (BMI), physical activity, nutritional health, quality of life, and health-related quality of life in Hispanic adults with diabetes (N = 59) using the PRECEDE-PROCEED planning model as a framework. Data were collected through face-to-face interviews at clinics and communities. A regression model with predisposing factors (age, BMI), and behavior (nutritional health and physical activity) significantly predicted quality of life (R 2 = 0.21, F = 3.63, p < .05) explaining 21% of variance. Physical activity and nutrition were the strongest predictors. Culturally competent intervention strategies must include factors that improve and enhance quality of life.

Health-Promoting Lifestyle and Diabetes Knowledge in Hispanic American Adults

This study examined the relationships among demographics, a health-promoting lifestyle, and diabetes knowledge. A descriptive study was conducted in a convenience sample of 40 Hispanic American adults. Participants were recruited from Hispanic churches in the southeastern United States. The Health Promoting Lifestyle Profile II and the Diabetes Knowledge Questionnaire were used to assess participants’ health-promoting lifestyle and diabetes knowledge. Participants had low levels of a health-promoting lifestyle and a strong deficiency in diabetes knowledge. Income was found to be associated with physical activity lifestyle. Age and education were significantly related to diabetes knowledge. This study suggested that community health nurses should assess and educate Hispanic American adults for a health-promoting lifestyle and diabetes knowledge and use appropriate methods of teaching with low-literacy and audiovisual materials to provide culturally specific care to this vulnerable group.

Exploring Parish Nursing from an Ethnographic Perspective

Purpose: This study examined a parish program as an evolving nursing specialty. Design: This is an ethnographic study of a parish nursing program in a southeastern U.S. city that included interviews with key informants, participant observations, and document analysis. Data were content analyzed. Findings and results: Findings indicate positive perceptions of the parish nursing program. Cultural themes include the process of discovery, commitment to the parish nurse and program, and fit with values and missions. Taxonomies of parish nurse attributes, actions, offerings, roles, and entrance requirements were derived. Discussion and conclusion: Parish nursing offers nurses the opportunity to bridge physical, social, emotional, and spiritual lives into one caregiving experience. Implications for practice: Findings provide clinical guidance for parish nurses.

A Community’s Awareness and Perceptions of Genomic Medicine

Background: Focus groups were conducted in a mid-sized community to explore community members’ awareness and perceptions of genomic medicine and identify effective methods to educate the public about this topic. Methods: Thirteen focus groups were conducted with a demographically representative pool of 121 participants using a semi-structured interview guide. Transcripts were analyzed through a computer assisted approach with Atlas TI consisting of coding, categorizing, comparing, and contrasting relevant data. Results: Identified categories were organized into 6 main themes, which were similar across the groups and included: a lack of awareness, perceived benefits, concerns about genomic medicine, reasons for poor health related behavior, the potential impact of genetic information on health behavior, and the best ways to educate the community. Common concerns included lack of affordability, unanticipated physical harm, mistrust of the government and researchers, downstream effects like overpopulation, playing God/disturbing the natural order, lack of regulations, loss of privacy, genetic discrimination, and moral dilemmas posed by genetic engineering, cloning, choosing traits, and abortions resulting from genetic information. Participants also discussed ways to educate the community. Conclusions: While individuals recognized that diseases run in families, personal experience was a driving factor in participants’ level of knowledge. Many expressed optimism about genomic medicine. However, the lack of depth in responses and their misconceptions reflect a deficiency of knowledge, which along with their personal, moral, and global concerns could impede acceptance and utilization of genomic medicine. Many community members are receptive to learning more about genomic medicine, and many of their concerns and misconceptions can be addressed through a well designed education strategy.

Recruitment and Retention of African American and Hispanic Girls and Women in Research

Recruiting women and girls into research studies, especially minority women, continues to be a major challenge that impacts health policy and delivery systems. This article discusses various strategies to recruit and retain African American and Hispanic girls and women in studies. Strategies for successful recruitment focus on trust, familiarity and visibility, racial and ethnic similarities, environmental context, and convenience. Retention strategies include issues of transportation, language, literacy, cultural appropriateness, safety, flexibility, incentives, communication, and veracity. All strategies assist in meeting the challenge of engaging minority women in research to decrease health disparities.

The Meaning of Insulin to Hispanic Immigrants With Type 2 Diabetes and Their Families

Purpose The purpose of this study was to explore the meaning of insulin among a sample of Hispanic immigrants with type 2 diabetes and their family members/significant others. Method Forty-three Hispanics with type 2 diabetes and their family members/significant others were recruited in the southeastern United States for a family-based intervention study on diabetes self-management. Focus groups were conducted in which participants with diabetes and family members were asked to describe their perceptions of insulin. The sessions were audiotaped and transcribed, translated from Spanish into English, and analyzed using standard content analysis. This article reports the findings as well as demographic information and hemoglobin A1C levels of participants. Results The meaning of insulin was described by both Hispanic immigrants with type 2 diabetes and their family members/significant others. Participants’ perceptions were categorized into three major themes: (1) negative perceptions of insulin therapy, (2) perceived barriers to insulin therapy, and (3) positive experiences with insulin emerged from qualitative data. Conclusions The Hispanic immigrants with diabetes and their family members/significant others in this study described perceptions and fears of insulin indicating a lack of understanding of the diabetes disease process and the progressive nature of diabetes. Strategies and further research are necessary to dispel negative perceptions and facilitate positive experiences with insulin for patients and family members/significant others.