Karen Heaton

Sleep Quality, Stress, Caregiver Burden, and Quality Of Life in Maternal Caregivers of Young Children With Bronchopulmonary Dysplasia

Little is known about the influence of sleep quality, stress, and caregiver burden on quality of life in maternal caregivers of young children with bronchopulmonary dysplasia (BPD). In 61 maternal caregivers (mean age 29.59 years) of young children with BPD (mean age 13.93 months), caregivers reported sleeping a mean of 5.8 hours, and significant correlations were found between sleep quality and depressive symptoms and stress, as well as an inverse correlation with quality of life. Sleep quality was found to be the most significant predictor of quality of life in maternal caregivers.

Sleep and cognition on everyday functioning in older adults: implications for nursing practice and research.

ABSTRACT Nearly 50% of older adults experience difficulty with sleeping, and 21% of older adults also experience cognitive complaints to which sleep difficulties can also contribute to poorer cognitive functioning. Combined, such sleep difficulties and age-related cognitive declines can contribute to poorer performance on everyday activities necessary for independence, quality of life, and successful aging. Activities that may be especially compromised are driving, instrumental activities of daily living, and employment. In nursing practice, it is necessary to understand the relationship between sleep and cognition and what contributes to poorer sleep hygiene and cognitive functioning, whether it is medications and polypharmacy, comorbidities, habits and lifestyle factors, or negative mood. Such an understanding can help nurses provide evidence-based interventions to improve sleep and cognition in older patients. In research, nurses must devise and test ways to improve sleep hygiene and cognitive functioning in older patients with methods such as sleep hygiene education and speed-of-processing training to ameliorate everyday functioning and quality of life.

An overview of nonpathological geroneuropsychology: implications for nursing practice and research.

ABSTRACT One aspect of successful aging is maintaining cognitive functioning, which includes both subjective cognitive functioning and objective cognitive functioning even in lieu of subtle cognitive deficits that occur with normal, nonpathological aging. Age-related cognitive deficits emerge across several domains including attention, memory, language, speed of processing, executive, and psychomotor, just to name a few. A primary theory explaining such cognitive deficits is cognitive reserve theory; it posits that biological factors such as demyelination and oxidative stress interfere with neuronal communication, which eventually produces observable deficits in cognitive functioning. Therefore, it is important to maintain or improve cognitive reserve to augment cognitive functioning in later life. This article provides a general overview of the principles of geroneuropsychology along with implications for nursing practice and research.

Identifying variables that predict falling asleep at the wheel among long-haul truck drivers

Analysis of data from 843 long-haul truck drivers was conducted to determine the variables that predicted falling asleep at the wheel. Demographics, sleep-specific questions, and the Epworth Sleepiness Scale were used for analysis. More than 25% of the participants (n = 247) scored 10 or higher on the Epworth Sleepiness Scale, indicating chronic sleepiness. Eight initial predictor variables were included in the logistic regression analysis. Four of the eight original variables were retained in the final model to predict falling asleep at the wheel within the past 12 months. Four variables were retained in the final model to predict falling asleep at the wheel within the past 30 days. Screening for excessive sleepiness using the Epworth Sleepiness Scale and an extensive history of medication use should be conducted for all long-haul truck drivers.

The effects of an online educational program on nurse practitioners’ knowledge of obstructive sleep apnea in adults

Purpose: This study was conducted to determine the effects of an online educational program on nurse practitioners (NPs) knowledge of identifying and evaluating adults at‐risk for obstructive sleep apnea (OSA). Data sources: Knowledge was assessed with a 15 question pre‐test and post‐test, after a 53 minute narrated PowerPoint educational session. Pre‐test and post‐test answers were compared to determine the change in knowledge. Fifty‐four participants entered the study, and 38 (70.4%) completed. Conclusions: NPs that completed the entire OSA program (n = 38) had a significant improvement in post‐test scores as compared to pre‐test scores (p < .001, t(37 = −5.024). This was particularly evident (p = .05) in the areas of clinical prevalence, routine health evaluation, signs and symptoms, high risk situations and screening tools. After the educational session, 97.4% of participants indicated they were “very likely” or “likely” to evaluate their patients for OSA. Implications for Practice: NPs have limited formal education on sleep disorders, although are in a key position to make a significant impact on evaluating adults for OSA. Regular screening to identify adults with OSA would likely lead to improving the rate of diagnosis and reducing the associated chronic health problems.Purpose This study was conducted to determine the effects of an online educational program on nurse practitioners (NPs) knowledge of identifying and evaluating adults at-risk for obstructive sleep apnea (OSA). Data sources Knowledge was assessed with a 15 question pre-test and post-test, after a 53 minute narrated PowerPoint educational session. Pre-test and post-test answers were compared to determine the change in knowledge. Fifty-four participants entered the study, and 38 (70.4%) completed. Conclusions NPs that completed the entire OSA program (n = 38) had a significant improvement in post-test scores as compared to pre-test scores (p < .001, t(37 = −5.024). This was particularly evident (p = .05) in the areas of clinical prevalence, routine health evaluation, signs and symptoms, high risk situations and screening tools. After the educational session, 97.4% of participants indicated they were “very likely” or “likely” to evaluate their patients for OSA. Implications for Practice NPs have limited formal education on sleep disorders, although are in a key position to make a significant impact on evaluating adults for OSA. Regular screening to identify adults with OSA would likely lead to improving the rate of diagnosis and reducing the associated chronic health problems.

The effects of arthritis, mobility, and farm task on injury among older farmers

The current study was conducted by performing secondary analysis of data drawn from a study of sustained work indicators of older farmers. The primary outcome variable was the reported occurrence or non-occurrence of injuries because of farm work in the past year. There were three explanatory variables of interest: (1) whether respondents reported ever having been diagnosed with arthritis/rheumatism by a medical doctor; (2) whether participants reported having mobility problems; and (3) a farm task injury risk index. Additional explanatory variables included the estimated number of days spent on farming activities in the past year, as well as demographic characteristics such as age, sex, and race. Institutional review board approvals were obtained for the original study prior to data collection, and for the current study prior to secondary analysis of data. Descriptive statistics were calculated for the outcome and explanatory variables. Initial multivariable longitudinal models for the occurrence of injuries were fitted with the explanatory variables. Odds ratios for the effects of interest were calculated using the final models. A longitudinal model was fitted using data in waves 1, 3, and 5, with a farm task injury risk index as outcome variable and wave, sex, age, race, and estimated number of days spent on farming activities in the past year as explanatory variables for exploration of the relationship between the farm task injury risk index and these variables. In this group of older farmers, aging was protective for injury, and was associated with decreased farm task injury risk index. Arthritis/rheumatism was associated in our study with occurrence of injury because of farm work across all four waves. Our results indicated that farmers with mobility problems were twice as likely to experience injuries because of farm work compared to farmers with no mobility problems. Increased farm task injury risk index was associated with a 40% increase in odds for the occurrence of injury due to farm work. In this study of older farmers, the type of work, and not the amount of work was significantly associated with injury risk. Implications for future studies of farm injury include the need for nurse researchers and others to incorporate objective validated measures of mobility and health care provider diagnoses of arthritis, and arthritis type. Nurse researchers should proceed with ongoing evaluation of the farm task injury risk index to determine its validity, reliability, and usefulness as a predictor of farm injuries. In the practice setting, nurses may apply findings from this study to provide injury prevention teaching to older farmers and their families. For example, discussions of the more risky farm tasks, injury prevention strategies, and treatment modalities including those that promote improved mobility should be targeted to older farmers with arthritis and actual or potential mobility issues. Ultimately, these nursing research and practice efforts may lead to preservation of function, and decreased injury risk and severity among older farmers.

Aging, Speed of Processing Training, and Everyday Functioning: Implications for Practice and Research

Studies show the importance of speed of processing in performing everyday activities such as safe driving. Unfortunately, normal nonpathological age-related changes in the brain can reduce speed of processing. Fortunately, speed of processing training exercises can improve driving ability, instrumental activities of daily living, and health-related quality of life. Speed of processing training may also prove invaluable in improving speed of processing in more cognitively vulnerable clinical populations, such as those with mild cognitive impairment and those aging with HIV. Implications for practice and research are posited.

Feedback actigraphy and sleep among long-haul truck drivers.

This pilot intervention study evaluated the effect of feedback actigraphy on sleep and sleep-related variables in a group of long-haul truck drivers. Visual feedback from actigraphs provided cues to the truck drivers, alerting them to their accumulated sleep times. Exposure to the cues was hypothesized to lead truck drivers to modify their behavior and result in improvement in sleep and sleep-related variables. It was predicted that exposure to feedback actigraphy would be associated with more sleep (quantity), better sleep (quality), a more positive attitude toward sleep, less subjective sleepiness, and increased control over sleep behavior by the sample.

The Useful Field of View Assessment Predicts Simulated Commercial Motor Vehicle Driving Safety

ABSTRACT Objective: The Useful Field of View (UFOV) assessment, a measure of visual speed of processing, has been shown to be a predictive measure of motor vehicle collision (MVC) involvement in an older adult population, but it remains unknown whether UFOV predicts commercial motor vehicle (CMV) driving safety during secondary task engagement. The purpose of this study is to determine whether the UFOV assessment predicts simulated MVCs in long-haul CMV drivers. Method: Fifty licensed CMV drivers (Mage = 39.80, SD = 8.38, 98% male, 56% Caucasian) were administered the 3-subtest version of the UFOV assessment, where lower scores measured in milliseconds indicated better performance. CMV drivers completed 4 simulated drives, each spanning approximately a 22.50-mile distance. Four secondary tasks were presented to participants in a counterbalanced order during the drives: (a) no secondary task, (b) cell phone conversation, (c) text messaging interaction, and (d) e-mailing interaction with an on-board dispatch device. Results: The selective attention subtest significantly predicted simulated MVCs regardless of secondary task. Each 20 ms slower on subtest 3 was associated with a 25% increase in the risk of an MVC in the simulated drive. The e-mail interaction secondary task significantly predicted simulated MVCs with a 4.14 times greater risk of an MVC compared to the no secondary task condition. Subtest 3, a measure of visual speed of processing, significantly predicted MVCs in the email interaction task. Each 20 ms slower on subtest 3 was associated with a 25% increase in the risk of an MVC during the email interaction task. Conclusions: The UFOV subtest 3 may be a promising measure to identify CMV drivers who may be at risk for MVCs or in need of cognitive training aimed at improving speed of processing. Subtest 3 may also identify CMV drivers who are particularly at risk when engaged in secondary tasks while driving.

Obesity, prediabetes, and perceived stress in municipal workers

The primary cause of death for men and women in the United States is heart disease. Obesity and diabetes are major contributors to heart disease, and the risk is worsened in the presence of stress. It is clinically useful to identify predictors of obesity and prediabetes in a working population. The purpose of this current cross-sectional, correlational study was to examine relationships among obesity, prediabetes, and perceived stress in municipal workers using a subset of worksite wellness program data from employees screened in 2010 and 2011. Multiple regression models indicated that age, gender, race, HA1c, shift schedule, physical activity, and occupation were significant predictors of obesity in municipal workers (p < .01). Prediabetes in municipal workers was predicted by age, Black race, and body mass index (BMI; p < .01). Perceived stress was not a significant predictor of obesity or prediabetes in municipal workers. Overall, the findings of this study provide guidance to occupational health nurses when evaluating individuals in an occupational health setting. Further research is needed to examine relationships among the variables and validate the models.