Kim Schafer Astroth

Merging health literacy with computer technology: Self-managing diet and fluid intake among adult hemodialysis patients

OBJECTIVE The Dietary Intake Monitoring Application (DIMA) is an electronic dietary self-monitor developed for use on a personal digital assistant (PDA). This paper describes how computer, information, numerical, and visual literacy were considered in development of DIMA. METHODS An iterative, participatory design approach was used. Forty individuals receiving hemodialysis at an urban inner-city facility, primarily middle-aged and African American, were recruited. RESULTS Computer literacy was considered by assessing abilities to complete traditional/nontraditional PDA tasks. Information literacy was enhanced by including a Universal-Product-Code (UPC) scanner, picture icons for food with no UPC code, voice recorder, and culturally sensitive food icons. Numerical literacy was enhanced by designing DIMA to compute real-time totals that allowed individuals to see their consumption relative to their dietary prescription. Visual literacy was considered by designing the graphical interface to convey intake data over a 24-h period that could be accurately interpreted by patients. Pictorial icons for feedback graphs used objects understood by patients. PRACTICE IMPLICATIONS Preliminary data indicate the application is extremely helpful for individuals as they self-monitor their intake. If desired, DIMA could also be used for dietary counseling.

Using a mobile application to self‐monitor diet and fluid intake among adults receiving hemodialysis

Hemodialysis patients have difficulty self-managing a complex dietary and fluid regimen. The purpose of this feasibility study was to pilot test an electronic self-monitoring intervention based on social cognitive theory. During a 6-week intervention, 24 participants self-monitored diet and fluid intake using the Dietary Intake Monitoring Application (DIMA), and 20 participants served as controls by monitoring their activity using the Daily Activity Monitor Application (DAMA). Results from this pilot study suggest the intervention is feasible and acceptable, although few significant effects on outcomes were found in this small sample. The DIMA has potential to facilitate dietary and fluid self-monitoring but requires additional refinement and further testing.

Construct validity of four exercise stage of change measures in adults.

Measuring readiness to exercise, or exercise stage of change (ESOC), is an important first step when counseling adults about exercise. However, minimal construct validity testing of ESOC measures has been reported. With a sample of 95 adults, we estimated the construct validity of four ESOC measures with commonly used response formats (true/false, ladder, 5 choice, interview). Participants completed all four ESOC measures in random order as well as six validation measures: physical activity performed, exercise self-efficacy, decisional balance pros and cons, and behavioral and experiential processes of change. Few participants were in the earliest stage of change. The true/false measure demonstrated the strongest validity. Further studies are needed in diverse samples with more representation across the stages of change.

Perceptions of New Nurses Concerning Incivility in the Workplace.

BACKGROUND Although an atmosphere of civility in which nurses respect and value each other is crucial to health care, incivility continues to be widespread. METHOD New graduate nurses completed an online questionnaire in which they described incivility and discussed its impact on new nurses and patients. RESULTS Findings were categorized according to the impact of incivility on new nurses and patients. Embedded in these categories are rich descriptions of incivility in health care. CONCLUSIONS The participants witnessed uncivil interactions that negatively impacted them emotionally, professionally, and physically. They also discussed the harmful effects of incivility on patients, whose care may be impeded or their faith in caregivers eroded in hostile, uncivil care environments. Nurses in professional development play a crucial role in promoting a culture of civility through raising awareness, supporting nurses new to the profession, and helping health care workers to better cope with incivility.

Non-Critical-Care Nurses' Perceptions of Facilitators and Barriers to Rapid Response Team Activation.

Rapid response teams can save lives but are only effective when activated. We surveyed 50 nurses for their perceptions of facilitators and barriers to activation. Findings showed that participants need more education on their role and when to activate the rapid response team. Nurses who comprise the team need help building their communication skills. We recommend nursing professional development specialists increase the frequency of offerings and expand the focus on roles, activation criteria, and communication skills.

Lessons from the Homeless: Civil and Uncivil Interactions with Nurses, Self‐Care Behaviors, and Barriers to Care

BACKGROUND Civility, rooted in social justice, is a fundamental value of nursing. Homeless people are particularly at risk for experiencing uncivil behavior from nurses. PURPOSE The purpose of this study was to explore homeless peoples perceptions of their interactions with nurses. METHOD In this descriptive, qualitative study, we interviewed 15 homeless adults who described their experiences with nurses. The interview guide, developed by the researchers, consisted of open-ended questions and probes. Transcriptions and field notes were analyzed through thematic analysis. RESULTS Three major themes emerged: nurses should be civil, self-care behaviors, and barriers to good care. Subthemes included listening, compassion, attentiveness, and judgment as components of civility; where they go for care and who cares for them as self-care behaviors; and lack of money and homeless status as barriers to care. CONCLUSIONS AND IMPLICATIONS Our findings indicate people who are homeless often perceive nurses to be uncivil and uncaring toward them; furthermore, our participants provide a unique description of healthcare interactions from the perspective of the homeless. These findings can be used as a basis for the development of education interventions for students and practicing nurses to assist them in learning to provide civil and compassionate care for the homeless.

Gambling and perceived health among adult jail inmates.

ABSTRACT Gambling problems have been associated with lower perceived health in community samples, but little research has examined this relationship in an incarcerated population. The purpose of this study was to determine the perceived health and gambling problems of adult inmates (18–49 years old) in a county jail. We surveyed 184 male and female inmates aged 18–49 years. Nearly 35% of inmates scored as problem or pathological gamblers, and inmates scored significantly lower on all Short Form-36 Version 2 perceived health scales than the U.S. population norm. There were no significant differences on perceived health scores between recreational and problem/pathological gamblers. The high prevalence of gambling problems and poor perceived health necessitates research to provide screenings and test effectiveness of gambling and health interventions in this population.

A Narrative Analysis of Sibling Grief

ABSTRACT Sibling grief is linked to serious physical and mental health outcomes, yet remains the least researched of all family bereavement. This exploratory study created a shared sibling grief narrative. Open-ended interviews were conducted with 27 participants who lost a sibling. Primary themes included Shared Life: Identity Within the Sibling Arrangement; Sibling Death: Pivotal Moments in Time; Life After Sibling Loss: Emotional Suffering, Life After Sibling Loss: Missing Roles & Changing Relationships; and The Sibling Lives On. The following study findings clarify the overlooked impact that sibling death has on the surviving sibling and demonstrate the crucial need for more sibling loss research.

Perceived Health and Gambling Behavior of Inmates: A Review of the Literature

PURPOSE An integrative review was conducted to determine perceived health and gambling behavior in incarcerated adults (ages 18-49), measures of perceived health and gambling behavior, and relationships between perceived health and gambling behavior. CONCLUSIONS Adult inmates report poorer perceived health and increased levels of gambling problems than those who are not incarcerated. No research investigating the relationships between perceived health and gambling among adult inmates was found. PRACTICE IMPLICATIONS Knowledge of relationships between perceived health and gambling can assist healthcare providers in understanding potential healthcare needs of the inmates and begin treatment while they are still incarcerated. Nurses in settings such as free and private clinics, homeless shelters, churches, and emergency departments need to screen for problem gambling in this population. This will facilitate appropriate referrals and continued treatment as these inmates transition back into society.

Social capital, health, health behavior, and utilization of healthcare services among older adults: A conceptual framework

Meeting the health needs of Americans must change as the population continues to live longer. A strategy that considers social well-being is necessary. One way to improve social well-being is through increased social capital, which includes networks among individuals and norms of reciprocity and trust between them. Supporting attainment of bonding social capital from close-knit groups, such as family, and bridging or linking social capital from those who are dissimilar are vital. Research shows there is a relationship among social capital and self-reported mental and physical health, health behaviors, healthcare utilization, and mortality. Because older adults are often dependent on others for their healthcare needs, it is posited that social capital plays a key role. Nurses can be instrumental in investigating levels of social capital for individuals and determining what type of social support is needed and who in the individuals network will provide that support. When support is absent, the nurse serves as the link between patients and available resources. The purpose of this article is to introduce a conceptual framework that can assist nurses and other healthcare providers to consider social capital in older adults in the context of relationships and the social environments to which they belong.