Linda L. Pierce

In-home online support for caregivers of survivors of stroke: a feasibility study.

The primary aim of this feasibility study was to determine if caregivers (n = 5) were willing and able to use Caring~Web©, a Web-based intervention for support, from their home Internet connection for 3 months. The caregivers’ perceived health and satisfaction with caring, as well as the care recipients’ use of healthcare services, were recorded. The experience of caring (problems and successes) was examined. Data were collected via weekly online surveys and e-mail discussions. Descriptive analyses revealed that the 3 caregivers who completed the study were satisfied with Caring~Web©. Caregivers rated their health as average to excellent and their satisfaction with caring as good. Care recipients averaged 6 calls/visits to a medical office with one emergency room visit and subsequent hospitalization. Major problems for the caregivers included dealing with medical conditions about which they lacked knowledge. Content analysis of the e-mail discussions revealed that subjects sought information about medical conditions related to caring for the survivor of the stroke. Major successes for the caregivers involved communicating effectively with the care recipient and returning to everyday life with family and friends.

Building a web of support for caregivers of persons with stroke.

Abstract Stroke is the leading cause of disability in the United States, with a cost of

Emotional support, physical help, and health of caregivers of stroke survivors.

30 billion annually. Most persons with stroke return home after initial treatment and are cared for by family members. Few researchers, however, have focused on Web-based interventions to strengthen caregivers’ efforts. This article describes the development of Caring∼Web©, an online, in-home intervention of support for caregivers of persons with stroke. Through specifically designed Web pages, caregivers are able to ask questions of a nurse specialist and rehabilitation team, discuss issues with other caregivers and the nurse via email, and obtain educational information on stroke.

Caregivers dealing with stroke pull together and feel connected

&NA; Guided by Orems self‐care deficit nursing theory, the purpose of this descriptive comparative study was to examine the emotional support, physical help, and health of caregivers of stroke survivors. Seventy‐three caregivers from the Midwest participated in a parent study that examined their experience of caring during the first 12 months after stroke. Caregivers were randomized to an online intervention of support and education (n = 36 Web users) or a control group (n = 37 non‐Web users). A secondary analysis of data collected during telephone interviews at baseline, 3, 6, and 12 months after stroke was performed. No significant mean differences were found between Web and non‐Web users in the above variables at these points in time. Consequently, the caregivers were merged into one group, and the relationships among the variables at the different points in time were analyzed. Significant, moderately positive relationships were found between emotional support and physical help at baseline, 3, and 12 months. There were also significant, moderately positive relationships between emotional support and caregiver health at 6 and 12 months. Results highlight the importance of caregivers (dependent care agents in Orems terms) establishing an adequate self‐care system that provides emotional support and physical help. Findings also denote the need for nurses (as caring agents) to assess caregiver health later in the caring process and be aware of its relationship to emotional support.

GERIATRIC FALLS: Prevention Strategies for the Staff

Changes that can accompany stroke may create considerable stress for individuals caring for the affected person. This study explored the coping process for nine rural-dwelling caregivers of persons with stroke and the responses of these caregivers to a Web-based support program. The qualitative data management program QSR N 5 was used to analyze quotes from telephone interviews and computer entries. Stories of how caregivers came together and supported one another emerged from the data collected as part of a larger study that examined the experience of caring. Friedemanns framework of systemic organization guided data analysis and interpretation. Actions demonstrated by the caregivers illustrated the process of crisis resolution through family togetherness in which nurses were included. The findings of this study aided in understanding this process and gave direction for nurses working with such clients.

What Are Male Caregivers Talking About

1. Multiple falls and injuries are more prevalent among elderly over the age of 75 and are the second leading cause of accidental death in the elderly. The risk for falling is noted to be significantly greater in the hospitalized elderly. 2. Review of retrospective quality improvement chart audits revealed that peak fall times were associated with the patients need for toileting, rest, and obtaining nutrition and hydration. 3. The MetroHealth Falls Prevention Program is based on simple proactive measures to prevent falls in the elderly. 4. An effective falls prevention program has several implications for gerontological nursing practice, including less restraint use, increased patient autonomy, and decreased loss of self-esteem. There is also a sense of increased nursing control over patient safety and time management, as well as implications for further nursing research.

Cardiac Therapy for Men with Coronary Artery Disease: The Lived Experience

Abstract Purpose: Using secondary analysis and Friedemann’s framework of systemic organization as a guide, the purpose of this article is to examine the experience of a subsample of five men caring for women with stroke who participated for 3 months in a Web-based support group. Method: Analysis of qualitative data (N = 224 entries) obtained from interview questions and discussion amongst the caregivers followed established protocols. Results: Results revealed that these men were dealing with role changes and women’s depression and irritability. The stroke event also fostered closer family ties and “being there” for one another. Conclusion: These findings begin to explore the complex experience of men caring for women with stroke.

Caregivers’ Incongruence: Emotional Strain in Caring For Persons With Stroke

A phenomenological inquiry was conducted to uncover the lived experience of cardiac therapy for men with coronary artery disease in Northwest Ohio. Five men age 60 to 70 years were purposively selected to participate. Data obtained from individual audiotaped interviews were analyzed using Colaizzi’s method. Eight major themes emerged: (a) feelings of fear and disbelief, (b) being aware of mortality, (c) losing control of self, (d) halting usual activities and future plans, (e) heightening awareness of spirituality and belief in a higher power, (f) resigning to accept external forces and required changes, (g) increasing sense of well-being, and (h) receiving a second chance and moving forward. This study makes valuable contributions to nursing by increasing awareness of actual lived experiences of cardiac therapy for men, offering direction for cardiac therapy programs to assist men with holistic lifestyle modifications that enable them to increase wellness, and serving as an impetus for further research.

Effect of a Professional Practice Model on Autonomy, Job Satisfaction and Turnover

Purpose: Guided by Friedemanns framework, the purpose of this study was to examine the dimensions of new family caregivers’ emotional strain in caring for persons with stroke. Method: Seventy‐three caregivers who were new to that role participated in an interview every 2 weeks for a year as part of a NIH project. Of these caregivers, 36 participants were randomly assigned and had access to a Web‐based intervention and its e‐mail discussion. In this secondary data analysis, 2,148 e‐mail discussion messages plus 2,455 narrative interview entries were used to examine dimensions of caregivers’ emotional strain. Rigorous content analysis was applied to these data. Results: The majority of these caregivers were white women with an average of 55 years who cared for spouses. Three themes emerged from these data: (1) being worried, (2) running on empty, and (3) losing self. Discussion: Caregivers worried about themselves and their care recipient, sharing feelings of being just “plain tired.” The caregivers felt that their lives were lost to giving care. They described in detail the emotional strain that they felt, as they took on new roles in caring for the person with stroke. Conclusion: This study informs nurses about new family caregivers’ emotional strain, or incongruence in Friedemanns terms, from their viewpoint and provides direction for supportive education interactions.

The Lived Experience of Aloneness for Older Women Currently Being Treated for Depression

Dissatisfaction and rapid turnover of registered nurses (RNs) challenge nurse administrators. The professional practice model (PPM) can increase the amount of personal control nurses have over their work. Use of a PPM allows innovation, promotes collegial relationships and emphasizes personal responsibility. In this study, facilitating an autonomous climate for RN practice resulted in increased job satisfaction and decreased.