Eileen Cormier

Attention Deficit/Hyperactivity Disorder: A Review and Update

Attention deficit/hyperactivity disorder (ADHD) is a prevalent, chronic, and pervasive childhood disorder characterized by developmentally inappropriate activity level, impulsivity, and inability to sustain attention and concentration. Core symptoms of the disorder are associated with impairment in multiple domains of functioning and often coexist with other psychiatric disorders, the most prevalent being oppositional defiant disorder, conduct disorder, depression, and anxiety disorders. Concerns have been expressed about the overdiagnosis of ADHD, an upsurge in prescription of stimulant medication, and wide variations in practice patterns related to diagnosis and treatment of children with ADHD among primary care providers. Clinical research and expert consensus guidelines over the past decade have increasingly clarified the most effective approaches to diagnosis and treatment of the disorder. Hence, the purpose of this article was to provide primary care providers with the most current, evidence-based information on the assessment and treatment of children with ADHD.

Cognitions associated with nurse performance: a comparison of concurrent and retrospective verbal reports of nurse performance in a simulated task environment.

BACKGROUND Cognitions represent the computations associated with human thought processes. Verbal protocols offer a method by which to record these processes. While concurrent and retrospective verbal reporting of cognitions have been used extensively within nursing and other domains, the use of this methodology in nursing has been characterized by inconsistencies in its application. OBJECTIVES The primary objective of this study was to describe and compare the content of concurrent and retrospective verbal reports provided by nurses during and after administering care in a simulated task environment. DESIGN The study utilized a laboratory based quasi-experimental research design. SETTING The study was based in a simulation laboratory designed specifically for use in studies designed to measure nursing performance. The laboratory integrated extensive instrumentation that facilitated the comprehensive audio and video recording of participant actions. PARTICIPANTS The participants (N=15) were recruited from a College of Nursing at a large university in the Southeastern United States. METHODS Research participants were asked to admit a patient experiencing an acute exacerbation of congestive heart failure in a simulated task environment, during which they were required to prioritize and provide care. Participants were trained in the method for providing verbal reports of thoughts, and concurrent and retrospective report data were collected during and after the simulation exercise. The data were then coded for the purposes of descriptive analysis. RESULTS The results indicated that the concurrent verbal reports provide a more complete representation of the cognitions of research participants providing care in a simulated task environment. However, the results reflect that additional unique data is present in the retrospective reports, exclusive of the concurrent reports. CONCLUSIONS The findings support the utility of concurrent and retrospective verbal reports as a method of gathering data in studies that address nursing performance in a clinical context.

How Parents Make Decisions to Use Medication to Treat Their Child’s ADHD A Grounded Theory Study

BACKGROUND: Despite evidence of efficacy, a substantial percentage of children with attention deficit hyperactivity disorder (ADHD) either do not begin medication prescribed for their core symptoms or fail to continue treatment. OBJECTIVE: The purpose of this study was to understand (a) how parents decide to use medication to treat their child’s ADHD and (b) the factors that influence their adherence to medication over time. DESIGN: Grounded theory guided data collection and analysis. Sixteen semistructured interviews with parents (13 mothers, 3 fathers) of children with ADHD were conducted. RESULTS: The substantive theory developed from the data demonstrates that in seeking to help their child and restore a sense of stability around family life, parents engage in a process of “doing what helps most” in deciding to use medication to treat their child’s ADHD. CONCLUSIONS: Interventions to support and guide parents throughout the decisional process are critical to meet the needs of families of children with ADHD.

Down Low Sex, Older African American Women, and HIV Infection

&NA; The phenomenon of down low sex, wherein men involved in monogamous relationships with women seek extrarelationship sexual relations with men, has gained recognition in recent years. This study addressed the issue of down low sex in a group of African American women whose long‐term sexual partners had become infected with HIV during extramarital sexual encounters with men. A grounded theory methodology was used to explore the experiences of 11 women in individual interviews that were sensitive to the intimate nature of their experiences. Themes shown in the data focused on (a) being betrayed and losing trust; (b) reflecting upon the features of the past relationship; (c) seeking the positive aspects of the past relationship; (d) being ashamed before God, community, and family; and (e) assuming the caregiver role and sharing the burden of illness. The study identified the strong influence of positive long‐term relationships on life decisions of women following a diagnosis of HIV, despite the extrarelationship sexual activities of their partners.

Identifying Health Consumers' eHealth Literacy to Decrease Disparities in Accessing eHealth Information.

The increasing amount of health information available on the Internet highlights the importance of eHealth literacy skills for health consumers. Low eHealth literacy results in disparities in health consumers’ ability to access and use eHealth information. The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that healthcare professionals can effectively address skills gaps in health consumers’ ability to access and use high-quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth Literacy Scale was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high- from low-quality information were considerably less. The findings suggest the need for eHealth education and support to health consumers from healthcare professionals, in particular, how to access and evaluate the quality of health information.

A study of the relationship of nursing interventions and cognitions to the physiologic outcomes of care in a simulated task environment

This study, based on the Expert Performance Approach, examined the clinical nursing performance of participants who were introduced into a simulated task environment requiring them to administer care to a client experiencing an exacerbation of Congestive Heart Failure. This was undertaken to identify cognitive and physiologic variables that differentiate performance levels among participants. Data on participant actions and verbal reports were coded to characterize their relationship with physiologic responses of the Human Patient Simulator. The results demonstrated that physiologic responses to nursing interventions reflect a reliable pattern that can be used to differentiate performance levels.

Intrapersonal and community factors associated with prostate cancer screening among African-American males in the US

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Depressive Symptoms and Influencing Factors in Low-Risk Mothers

ABSTRACT Introduction: Depressive symptoms burden not only postpartum women, but can also compromise partner relationships and mother–infant interactions. With approximately 15% of women affected by perinatal mood and anxiety disorders (PMADs) each year, maternity care providers must be sensitive to personal characteristics and complaints that influence womens potential to develop postpartum depression (PPD). The purpose of the study was to identify personal characteristics and modifiable factors associated with depressive symptoms in low-risk postpartum women. Methods: A descriptive, correlational design was used to identify predictors of depressive symptoms among mothers who were considered to be at low risk for PPD. Self-report data related to mood, stress, sleep disturbance, and fatigue were collected near the sixth week post-delivery from women (N = 62) in a southern US state. Results: The levels of stress and reports of sleep disturbance approached clinical concern in the low-risk sample (n = 62), in addition to being positively correlated depressive symptoms. Cesarean delivery was also associated with increased depressive symptoms and predictive of depression symptoms when combined with perceived chronic stress, sleep disturbance, and fatigue. Discussion: The findings underscore the importance of assessing maternal mental health and adjustment during the postpartum period. While some mothers may not report depressive symptoms at post-delivery visits, they may be experiencing symptoms that predispose them to a mood disorder. Using a more holistic approach to postpartum care, with concern for both physical and mental well-being, may be a necessary shift to promote health in new mothers and families.