Erlinda C. Wheeler

Cancer caregivers online: hope, emotional roller coaster, and physical/emotional/psychological responses.

The demands placed on cancer caregivers are well documented. Support for informal caregivers has been shown to increase hope and decrease psychosocial morbidity. The Internet is a readily available means of support for cancer caregivers, however little research on online support for informal caregivers of cancer patients exists. Descriptive statistics and qualitative analysis were used to evaluate messages posted over a 2-month period on an online cancer caregiver listserv. Three major themes emerged from the data: hope, emotional roller coaster, and physical/emotional/psychological responses. Supportive and hopeful statements prevailed among online participants in the current study. However, subjects also described the emotional roller coaster associated with caregiving. Emotional/physical/psychological responses included anger, weakness, exhaustion, grief, and sadness. Outcome research is needed to help evaluate the efficacy of online support for caregivers. Findings in this study can help nurses focus on some problems common to caregivers of cancer patients and plan appropriate interventions and research.

Time, Tact, Talent, and Trust: Essential Ingredients of Effective Academic-Community Partnerships

Building strong partnerships between academic institutions and community health agencies requires a commitment to time, tactful communications, talented leaders, and trust. The essential elements of partnership building are discussed based on experiences of a mid-Atlantic nursing center, an academic health center established to provide care to underserved and vulnerable populations.

Telephone Interventions by Nursing Students: Improving Outcomes for Heart Failure Patients in the Community

Community care for heart failure patients is difficult due to multiple comorbidities, polypharmacy, and advanced age of patients. Studies show that hospital admissions and emergency room visits decrease with increased nursing interventions in home and community settings. The purpose of this study1 was to assess the effectiveness of regular telephone interventions by nursing students on outcomes of heart failure patients in the home. Senior students were paired with community nursing staff and assigned 2 heart failure patients to follow up by telephone calls for 12 to 14 weeks. Patients who received telephone interventions had fewer hospital readmissions (13%) than the comparison group (35%). Patients in the telephone intervention group also had fewer overt heart failure symptoms as measured by the Minnesota Living With Heart Failure Questionnaire.

Symbiosis--undergraduate research mentoring and faculty scholarship in nursing.

Although teaching is the major focus of academia, research and professional publications frequently determine faculty eligibility for promotion and tenure. In universities where funded research is scarce, faculty need creative means to accomplish research goals. Research is an essential part of baccalaureate nursing education. The goal of research education at the baccalaureate level is to prepare knowledgeable consumers in nursing research. The purpose of this article is to describe an undergraduate nursing research course that provide students with hands-on experience in the conduct of nursing research and provide faculty with assistance in moving their research agenda forward. Faculty members were solicited to work with 5-10 students in a research project that was either in the planning stages or actively in progress. After one year of program implementation, faculty and students were involved in presenting poster and oral presentations at state, regional, and international research conferences. Manuscripts and proposals for funding are in the process of submission.

Asian/Pacific Islander American women: age and death rates during hospitalization for breast cancer.

PURPOSE/OBJECTIVES To investigate whether differences in age and death rates exist between hospitalized Asian/Pacific Islander American (APIA) women and women of other racial groups. DESIGN Secondary data analysis of a national data set. SETTING The Healthcare Cost and Utilization Project Nationwide Inpatient Sample, Release 6, was used to obtain hospitalization data on women with breast cancer based on racial status. A total of 20,507 hospitalization records met the study criteria. SAMPLE All women who were hospitalized with a primary diagnosis of breast cancer, were older than 18, and did not die during hospitalization, plus all women who met the criteria stated above but died during hospitalization. METHODS Secondary data analysis. Post hoc analysis was used to identify significant differences among racial groups. FINDINGS Significant differences were found between APIA and Caucasian and Latino women. Significant differences based on race were found between subjects who had died during hospitalization. On average, APIA women were the youngest to die. CONCLUSIONS APIA women with breast cancer were among the youngest women being hospitalized and the youngest to die during hospitalization. IMPLICATIONS FOR NURSING Cultural awareness by nurses is critical when discussing methods for prevention and early detection of breast cancer with minority women. Targeting new immigrants is a priority for those who screen and educate women about detection and treatment of breast cancer.

Psychological impact of implantable cardioverter defibrillator on their recipients.

This 12-month longitudinal prospective study tracked the depression and anxiety levels of implantable cardioverter defibrillator recipients after implantation of the device. Depression and anxiety levels dropped significantly over time. These findings suggest that interventions should be implemented early because the needs are greatest in the first few weeks after device implantation.

Racial Disparities in Hospitalized Elderly Patients with Chronic Heart Failure

The purpose of this study was to examine the impact of race on length of hospital stay (LOS) and number of procedures on elderly persons hospitalized with chronic heart failure (CHF). Secondary data analysis was used to obtain data on 99,543 hospitalized Medicare patients with CHF age 65 years or older. MANOVA was utilized to examine the effects of race, age, and total hospital charges on LOS, number of procedures, and diagnosis. Asian American Pacific Islanders had significantly higher number of procedures and LOS compared to Whites. The combined dependent variables were significantly affected by race, F(9, 99,543) = 121.95, p = .000; the covariates of age, F(3, 99,543) = 720.65, p = .000; and total charges F(3, 99,543) = 38,962.95, p = .000. LOS accounted for 50% of the variance. Studies that examine cultural variables and their effect on LOS and number of procedures are needed.

Characterising emergency department high-frequency users in a rural hospital

Objective Patients who are frequent users (≥4 visits/year) comprise ∼10% of patients, but account for ∼34% of total yearly emergency department (ED) visits. Non-emergent care provided to frequent ED users affects operating costs and usage. The majority of reports characterising frequent ED use are from urban teaching centres. This study describes frequent users of ED services in a rural community setting and the association between counts of patients visits and discrete diagnoses. Design Retrospective study of 1652 frequent ED adult patients from a rural US hospital over a one-year period. Descriptive statistics and Poisson regression were used to explore the characteristics of frequent users and their patterns of diagnoses. Results Frequent user visits ranged from 4 to 66 per patient. Frequent users were 9.41% of patient volume accounting for 33.94% of the total visits and were younger compared with patients with <4 visits. Approximately 36% of frequent user visits were generated by 20 diagnoses when the diagnoses were concatenated into domains which covered ∼76% of the visits. There was a high correlation between the number of visits and discrete diagnoses in frequent users. Conclusions These findings suggest a more complex picture of rural ED services and their relationship with primary care and dental services, which needs to be defined before policy development to reduce ED use.

Engaging nurses in research utilization.

Research skills education is needed for nurses at all levels: novice, intermediate, and advanced. Nurse educators can help novice nurse researchers develop skills such as performing literature searches and critiquing research articles, which are necessary to develop and update clinical practice guidelines and implement evidence-based practice. The purpose of this article is to describe an innovative approach to encourage nurses to perform literature searches and critique research articles as a means to eventually engage in evidence-based practice.

Critical care leadership course: a recruitment and retention strategy.

This article describes how to implement a baccalaureate level course in critical care leadership and management and emphasizes the value of this course in recruiting and developing critical care nurses with leadership abilities.