Jean D'Meza Leuner

Social Support, Quality of Life, Immune Function, and Health in Persons Living with HIV

The purpose of this study was to examine the relationship between social support and quality of life in individuals with HIV. Using a descriptive, correlational design, data were collected from 50 HIV-positive individuals who were: (a) participants in support groups at a behavioral medicine unit, (b) inpatient or respite care patients with HIV, or (c) respondents to advertisements at AIDS service organizations. Instruments used for data collection were the Personal Resource Questionnaire 85-Part 2 (Weinert, 1987), measuring perceived social support, and the Quality of Life Index (QLI) (Ferrans & Powers, 1985), measuring the sense of well-being in life including the satisfaction with and importance of life domains with four subscales: health and functioning, socioeconomic, psychological/spiritual, and family. The results of the study indicated that social support was significantly correlated with quality of life (r = 0.81, p < 0.0001). Further, HIV status (a symptomatic HIV symptomatic HIV, AIDS) was significantly related to quality of life (p < 0.01). However, HIV status was not significantly related to social support. No significant relationship was found between CD4 counts and HIV status, CD4 counts and social support, or CD4 counts and perceived health status. However, CD4 counts were significantly correlated with scores on the QLI. The findings of the study indicate that social support and quality of life are significantly intercorrelated and that higher CD4 counts are related to quality of life in this sample of persons living with HIV. Further areas for research include evaluation of quality of life over the span of HIV disease and interventions aimed at enhancing or maintaining quality of life in persons across the spectrum of HIV disease.

A PROPOSED FRAMEWORK for Differentiating the 21 Pew Competencies by Level of Nursing Education

Now nearly a decade old, the original Pew Health Professions Commission Competencies have stood up well to the test of time. The competencies were designed to provide all health professionals, from physicians to physical therapists, with a general guide to the values, skills, and knowledge they would need to be successful in the health care system that was beginning to emerge in the late 1980s. They have been used across the range of health professions and in many practice settings to create a framework for curricular change, work redesign, and assessment of professional competence. The interpretation of the competencies offered here should prove to be a useful tool to nurses and health system leaders as they carry on the hard work of adapting the current model of nursing practice to the demands and realties of the contemporary and continually evolving health care environment. This work is important for two reasons. First, many of the skills and attributes of the professional nurse are not adequately used or valued by the health care system because the profession is both fragmented and poorly differentiated and articulated. Without markers that define and promote collaborative practice within nursing, the full potential of nurses at all levels of preparation will continue to be inadequately and inappropriately deployed. This model exacerbates the current nursing shortage because it fails to use nurses in appropriate, well-delineated, and challenging roles. Without this kind of differentiation, one that can be owned and supported by all nurses, there will continue to be suboptimal use of the nursing workforce in the United States. The framework of differentiated Pew competencies and the companion teaching-learning strategies proposed here offer one approach to rationalizing both nursing education and practice, with the potential for improving the quality of care, and reducing fragmentation, cost, and public confusion.

Integrating Research, Practice, and Education

Abstract The history of nursing education in the united states reveals an interesting journey from hospital-based training to academically based education. While all of us in nursing would agree that claiming our position as an independent profession and discipline required an important and fundamental shift, there have been consequences for the profession. As many nursing faculty pursue full-time doctoral study and engage in such scholarly endeavors as publishing and grant writing, little time remains for clinical practice. It is simply not viewed as a priority in an overloaded teaching and research schedule. • Over time, this trend has contributed to an increasing disconnect between the academic-educational arena and the clinical-service sector. Unintended effects have been difficulty in maintaining teaching content infused with current clinical examples, limited access to clinical populations for research investigations, and few demonstration projects and experimental units for nursing practice. It is ...

Relationship between body image and chronic obstructive pulmonary disease

T HE IMPACT OF A chronic illness may significantly alter how an individual views the self. Chronically ill individuals must cope with alterations in their health status which may lead to body image disturbance. For individuals with Chronic Obstructive Pulmonary Disease (COPD), rigorous therapeutic interventions such as respiratory therapy, medication regimes, and proper nutrition are focused on maximizing functional capabilities. The psychological well-being of individuals with COPD can be affected due to the physical changes and lifestyle alterations that result from this chronic condition. A change in the body can influence ones feelings of self-worth and self-esteem and further compromise functional abilities. The purpose of this study was to explore the relationship between body image and the presence of the chronic illness of COPD. This illness was chosen because it represented a chronic condition that may require integration of physical changes into the individuals view of the self. Assessment of changes in body image in individuals with COPD may be important in the planning and implementation of nursing care. Diekmann (1988) has suggested that both adaptation and quality of life may be inextricably related to the individuals view of his or her body. This study was conducted in a large urban hospital. All patients with a diagnosis of moderate (n = 37) or severe (n = 50) COPD who visited the pulmonary outpatient clinic during a l-year period were interviewed. Severe COPD was defined as the forced expiratory volume in 1 second divided by the forced vital capacity percentage predicted (FEV 1%) of less than 50%, which indicates severe airway obstruction. Moderate COPD was defined as an FEV 1% value between 50% and 60%, which indicates moderate airway obstruction. A comparison group of 49 healthy subjects was obtained from various departments and professional organizations within the hospital setting. Individuals who indicated they were in excellent or good health were included in the study. Body cathexis, the degree of feeling of satisfaction or dissatisfaction with various parts or processes of the body and the self, was measured by the Body Cathexis/Self Cathexis Scales originally developed by Secord and Jourard (1953). The Body Cathexis Scale (BCS) consists of 46 body parts and functions. Subjects indicate their feelings on each of the 46 items on a scale of 1 (have strong feelings and wish changes could be made) to 5 (consider myself fortunate). The Self Cathexis Scale (SCS) lists 55 items that represented various conceptual elements of the self. Subjects rate these aspects of the self on a scale of 1 (wish changes could be made) to 5 (consider myself fortunate). In the original study, Secord and Jourard (1953) found split-half reliability coefficients that ranged from .78 to .92 for the two scales. Healthy subjects and subjects in both COPD groups completed the BCS and SCS. The mean age for healthy subjects was 50 years (SD = 9.19). For the individuals with moderate COPD, mean age was 58 years (SD = 7.22), and mean age was 55 years (SD = 10.10) for individuals with severe COPD. Mean scores on the BCS and the SCS are presented in Table 1. After finding significant ANOVAs for the BCS and SCS, comparisons were made among healthy individuals, individuals with moderate COPD, and individuals with severe COPD using Bonferroni post-hoc analyses. Each of these three groups differed significantly from each other. Healthy subjects had the

Thirteen years and counting. Outcomes of a concurrent ASN/BSN enrollment program

In their 2011 report, The Future of Nursing, the Institute of Medicine called for 80% of the nursing workforce to be comprised of baccalaureate prepared Registered Nurses by the year 2020. One suggested approach to achieve this goal is the creation of programs that allow students to progress through associate and baccalaureate nursing preparation simultaneously. This paper describes the University of Central Floridas 13-year experience after implementing a Concurrent Enrollment Program. Development and structure of the program, advisement and curriculum details, facilitators and barriers are described. Data on National Council Licensure Examination for Registered Nurses pass rates, completion rates, comparison with traditional RN-BSN students, and progression to graduate school are also included. The Concurrent Program model described here between a specific university and state college partners, demonstrated positive outcomes that support achievement of the Institute of Medicines goals.