Evelyn M. Clingerman

Health literacy among older adults: a systematic literature review.

The purpose of this systematic literature review was to describe the empirical findings on health literacy in adults 65 and older. A systematic search for research studies from 1999 to early 2010 was conducted in MEDLINE and CINAHL databases. Articles were analyzed using the following foci: skills and health knowledge, functional health literacy, and health behaviors and health outcomes. Findings indicated that advancing age resulted in a significant increase in prevalence of inadequate health literacy. Further research is needed to develop evidence-based, culturally congruent interventions to improve health literacy among older adults.

Physical Activity, Social Support, and Health-Related Quality of Life Among Persons With HIV Disease

The Centers for Disease Control and Prevention estimate that 800,000 to 900,000 Americans live with HIV disease (HIVD) and that it is transmitted to 40,000 others annually. Biomedical research has focused on finding a cause and cure, including early detection techniques and pharmacologic therapies to extend life. Meanwhile, persons with HIVD continue to face multiple challenges as they live with symptoms and the effects of treatment modalities that affect their quality of life. The purpose of this investigation was to identify and explore relations among physical activity (PA), social support, and health-related quality of life (HRQOL) in persons with HIVD who were living in community settings. Findings indicated a significant inverse correlation between participants HRQOL and meeting moderate or vigorous PA recommendations from Healthy People 2010, but weekly frequency of participating in at least 30 min of moderate or vigorous PA was significantly (r = .49, p < . 01) correlated with HRQOL. Friend social support and weekly frequency of PA accounted for 37% of the variance in HRQOL in a regression analysis.

Participation in Physical Activity by Persons Living With HIV Disease

Physical activity (PA) may offer substantial health benefits for persons with HIV disease. The purpose of this study is to describe and explore physical activity behaviors in a sample of persons living with HIV disease. This descriptive correlational study surveyed 78 persons (n = 70 men; n = 8 women) from two outpatient settings. Results showed somewhat fewer of the participants met Healthy People 2010 PA recommendations than persons in the general population. Walking was the preferred PA. Average functional social support was significantly correlated with (a) weekly frequency of performing moderate 30-minute PA (r = .38, p < .01) and (b) HIV-RNA (viral load) values (r = -.37, p < .05). Significant correlations were also found between scores on general health status self-reported CD4+ cell counts (.33, p < .05) and HIV-RNA (.39, p < .05) values. Total friend functional social support was significantly (.32, p < .01) correlated with weekly frequency of moderate or vigorous PA.

Social Justice A Framework for Culturally Competent Care

Nurse scholars with expertise in global health and culturally competent care recently proposed standards of practice for culturally competent nursing care that are founded on social justice as a broad framework. The purpose of this article is to respond to invited dialogue about the standards and to offer commentary on social justice and its relationship with context, advocacy, leadership, and culturally competent care. A model of culturally competent care for vulnerable groups informs this discussion. The context and culture that surround migrant and seasonal farmworkers illustrate how social justice illuminates their health inequities and necessitates their need for culturally competent care. The article concludes with recommendations for culturally competent education, practice, and research and offers suggestions for developing culturally competent interventions for migrant and seasonal farmworkers.

A Medical-Surgical Nurse's Perceptions of Caring for a Person With Severe Mental Illness

Background: When hospitalized for medical conditions, many people with severe mental illness (SMI) have poor outcomes, yet little is known about contributing factors. Studies exploring the care experience from nurses’ perspectives described care processes as “difficult.” None of these studies were conducted in the United States, and sociocultural contexts significantly affect perceptions of SMI. Objective: The purpose of this inquiry was to explore a medical–surgical nurse’s perceptions of caring for a hospitalized person with SMI in the United States. Design: A qualitative, descriptive case study was used. RESULTS: The nurse’s experience was characterized by categories of tension, discomfort, lack of professional satisfaction, and difficult. Conclusions: This case study revealed a negative care experience, similar to conclusions of investigations conducted in other countries. Understanding of nurses’ care experiences can inform efforts to improve practice environments, provide resources, or develop models of care that support nurses who care for patients with SMI and improve health outcomes for people with SMI.

The influence of resources on perceived functional limitations among women with multiple sclerosis.

The purpose of this longitudinal investigation was to identify the effects of external resources (i.e., education, marriage, employment, social support, economic status) on the trajectory of perceived functional limitation among women with multiple sclerosis (MS). We hypothesized that these resources would have a long-term influence upon MS-related functional limitation. As part of a longitudinal study of health promotion and quality of life among persons with MS, we tested hypothesized relationships using data obtained at five time points, using repeated-measures MANOVA. We found that functional limitation scores increased over time for all participants. In general, women who were unemployed as a result of MS consistently had higher functional limitation scores, and employed women consistently had lower functional limitation scores. Women with lower social support scores consistently perceived greater functional limitation than those with higher social support scores. Women with lower perceived-economic-adequacy scores consistently had higher functional limitation scores than women with higher perceived-economic-adequacy scores. Nurses and other healthcare professionals are in an optimum position to observe and assess the resources of women with MS. They can use presence, listening, and observational skills to identify verbal and nonverbal cues of resource depletion. In addition, they can act as advocates for women with MS and speak out on policy issues and legislation at the local and national levels. Healthcare professionals can thus influence the presence of resources for those who are particularly vulnerable to resource loss, so they can participate successfully in work, recreational, and home environments.

Stress in Migrant Farmworkers During Premigration

Purpose: This study explored the relationship between migrant farmworker (MFW) stress and salivary cortisol (sC) in a sample of MFWs prior to migration. Sample: The sample, 40 (N = 14 male, 26 female) adult MFWs residing in the lower Rio Grande Valley of Texas, primarily comprised middle-aged immigrants with a middle-school education. Design: This pilot feasibility study included a self-report farmworker stress inventory and five serial sC specimens in 24 hr. Results: The sC measures reflected an expected diurnal pattern. Lower total cortisol (area under the curve with respect to ground) was significantly associated with greater waist circumference (r = –.63, p ≤ .01). Repeated measures analysis of variance (ANOVA) indicated that participants who perceived high levels of farmworker stress exhibited a significant change in sC over time; F(2.14, 72.65) = 43.90, p < .001. High- and low-perceived-stress groups differed significantly in the trajectory of changes in sC over the five time points. Conclusion: MFWs experienced significant levels of stress during premigration. Their sC responses varied significantly by level of perceived farmworker stress. Lower perceived stress may reflect blunting of the sC response pattern.

Bereavement Tasks for Nursing Students

Preparing students to face the loss of patients through suffering and death is not an easy task. The author describes two separate and unique teaching/learning strategies that provided nursing students with practical applications to cope with their bereavement experiences during an oncology clinical rotation. The articles emphasis is on the critical need of adequate and contemporary clinical integration of death and bereavement concepts and nursing education.

Foundations for social justice-based actions in maternal/infant nursing.

The purpose of this article is to discuss health disparities and inequities and their most significant effects on maternal/infant health. A literature background on the social context of justice and distinct ethical theories is provided. Different ethical approaches to guide interventions that can improve the health of mothers and infants are presented. By adopting an ethical framework of social justice, nurses can better understand and thus influence outcomes and ameliorate health disparities and inequalities.

Creation of an American Holistic Nurses Association Research Consultation Program

A goal of the American Holistic Nurses Association (AHNA) Research Committee is to prepare holistic nurses to conduct holistic nursing research. This article describes the creation of a Research Consultation Program and how the knowledge gained from the program will contribute to the development of a formal research mentor program.