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Friedmann E, Gee NR, Simonsick EM, Kitner-Triolo MH, Resnick B, Adesanya I, Koodaly L, Gurlu M. Pet ownership and maintenance of cognitive function in community-residing older adults: evidence from the Baltimore Longitudinal Study of Aging (BLSA). Sci Rep 2023; 13:14738. [PMID: 37679499 PMCID: PMC10484936 DOI: 10.1038/s41598-023-41813-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023] Open
Abstract
Pet ownership has been associated with reduced deterioration in physical health as older adults age; little research focused on deterioration in cognitive function. We examine the relationship of pet, dog, cat ownership, and dog walking to changes in cognitive function among 637 generally healthy community-dwelling older adults (185 pet owners) aged 50-100 years (M = 68.3, SD = 9.6) within the BLSA. Cognitive assessments every 1-4 years over 1-13 years (M = 7.5, SD = 3.6) include the California Verbal Learning (Immediate, Short, Long Recall); Benton Visual Retention; Trail-Making (Trails A, B, B-A); Digit Span; Boston Naming (Naming); and Digit Symbol Substitution (Digit Symbol) Tests. In linear mixed models, deterioration in cognitive function with age was slower for pet owners than non-owners (Immediate, Short, Long Recall; Trails A,B,B-A; Naming; Digit Symbol); dog owners than non-owners (Immediate, Short Recall; Trails A,B; Naming; Digit Symbol); and cat owners than non-owners (Immediate, Short, Long Recall; Naming), controlling for age and comorbidities. Among dog owners (N = 73) walkers experienced slower deterioration than non-walkers (Trails B, B-A; Short Recall). All ps ≤ 0.05. We provide important longitudinal evidence that pet ownership and dog walking contribute to maintaining cognitive function with aging and the need to support pet ownership and dog walking in design of senior communities and services.
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Affiliation(s)
- Erika Friedmann
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Suite 402, Baltimore, MD, 21201, USA.
| | - Nancy R Gee
- Department of Psychiatry, Center for Human Animal Interaction, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Melissa H Kitner-Triolo
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Barbara Resnick
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Suite 402, Baltimore, MD, 21201, USA
| | - Ikmat Adesanya
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Suite 402, Baltimore, MD, 21201, USA
| | - Lincy Koodaly
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Suite 402, Baltimore, MD, 21201, USA
| | - Merve Gurlu
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Suite 402, Baltimore, MD, 21201, USA
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Friedmann E, Gee NR, Simonsick EM, Barr E, Resnick B, Werthman E, Adesanya I. Pet Ownership and Maintenance of Physical Function in Older Adults-Evidence From the Baltimore Longitudinal Study of Aging (BLSA). Innov Aging 2023; 7:igac080. [PMID: 36915903 PMCID: PMC10006577 DOI: 10.1093/geroni/igac080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Indexed: 12/26/2022] Open
Abstract
Background and Objectives Pet ownership or human-animal interaction has been associated with better health outcomes in individuals with disease or disability. We hypothesized that pet ownership, as well as dog ownership and cat ownership separately, are associated with maintaining physical function, and leisure time physical activity and that among dog owners, dog walking is associated with maintaining these outcomes for generally healthy community-dwelling older adults participating in the Baltimore Longitudinal Study of Aging. Research Design and Methods A total of 637 men (44.1%) and women aged 50-100 years (M = 68.3, standard deviation [SD] = 9.6) completed a comprehensive pet ownership questionnaire that ascertained pet ownership history 10-13 years and had serial assessments of physical function every 1-4 years prior. Linear or generalized linear mixed models with time varying pet ownership were used to examine change in physical function over a mean of 7.5 years (range 1-13, SD = 3.6) according to pet ownership. Results Pet owners (n = 185) were significantly younger (p < .001) and had fewer comorbidities (p = .03) than nonowners; thus, age and comorbidities were included as covariates in the longitudinal analyses. Physical function and leisure time physical activity declined with aging across all outcomes (p < .001); the decline was slower among pet owners in overall physical performance (p < .001), rapid gait speed (p = .03), usual gait speed (p = .032), cardiorespiratory fitness (p < .001), and physical well-being (p = .002) controlling for age and comorbidities. Changes in leisure time physical activities with aging did not differ between pet owners and nonowners. Dog walking was not independently related to the maintenance of physical function or leisure time physical activity with aging. Discussion and Implications This study provides the first longitudinal evidence that pet ownership is associated with maintained physical function among community-dwelling generally healthy older adults.
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Affiliation(s)
- Erika Friedmann
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Nancy R Gee
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Erik Barr
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Emily Werthman
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Ikmat Adesanya
- University of Maryland School of Nursing, Baltimore, Maryland, USA
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Friedmann E, Gee N, Simonsick E, Kitner-Triolo M, Barr E, Resnick B, Adesanya I, Gurlu M. PET OWNERSHIP AND MAINTENANCE OF EXECUTIVE FUNCTION IN OLDER ADULTS– EVIDENCE FROM THE BLSA. Innov Aging 2022. [PMCID: PMC9767152 DOI: 10.1093/geroni/igac059.3028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Pet ownership (PO) or human-animal interaction (HAI) has been associated with better physical and mental health in individuals with existing disease or disability. In experimental studies, HAI improves some aspects of cognitive function. No research addresses HAI and longitudinal changes in cognitive function in older adults. We examined the relationship of PO to maintaining executive function (EF) within generally healthy community-dwelling older adults in the Baltimore Longitudinal Study of Aging (BLSA). We hypothesized less EF deterioration among pet owners than non-owners; and less deterioration among dog-walkers than owners who don’t walk their dogs. 637 women (55.9%) and men aged 50–100 years (M=68.3, SD=9.6) completed a PO questionnaire which ascertained ownership history and comprehensive examination every 1–4 years over 1–13 years (M=7.5, SD=3.6). Linear mixed models with time varying PO examined changes in EF according to PO. Pet owners (n=185) were younger (p < 0.001) and healthier (p=0.030) than non-owners; thus, age and comorbidities were included as covariates in the longitudinal analyses. EF, assessed using the Trail-Making Test (TMT), deteriorated with age (p’s < 0.001). Deterioration was less severe among pet owners than non-owners (TMT A: p < 0.001; B: p < 0.001; difference: p=0.042) and dog owners than non-owners (TMT A: p=0.025; B: p=0.009; difference: p=0.076), but not among cat owners than non-owners. Among dog owners (n=73), dog walkers experienced less deterioration than non-walkers (TMT A: p=0.156; B: p=0.001; difference: p < 0.001). This study provides the first longitudinal evidence that PO may contribute to maintaining EF among community-dwelling generally healthy older adults as they age.
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Affiliation(s)
- Erika Friedmann
- University of Maryland Baltimore, Baltimore, Maryland, United States
| | - Nancy Gee
- Virginia Commonwealth University, Richmond, Virginia, United States
| | | | | | - Erik Barr
- University of Maryland School of Nursing, Baltimore, Maryland, United States
| | | | - Ikmat Adesanya
- University of Maryland, Baltimore, Maryland, United States
| | - Merve Gurlu
- University of Maryland Baltimore, Baltimore, Maryland, United States
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Moen M, Doede M, Johantgen M, Taber D, Adesanya I, Werthman E, Friedmann E. Nurse‐led hospital‐to‐community care, clinical outcomes for people living with
HIV
and health‐related social needs. J Adv Nurs 2022; 79:1949-1958. [PMID: 36345144 DOI: 10.1111/jan.15485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/09/2022] [Accepted: 10/19/2022] [Indexed: 11/10/2022]
Abstract
AIMS To evaluate whether patients with HIV enrolled in Linkage to Care (hospital-based only) or Linkage to Care Plus (nurse-led hospital-to-community transitional care) programmes fare better on clinical outcomes; and to investigate how factors such as substance use, mental health or health-related social needs contribute to these outcomes. BACKGROUND Social determinants of health contribute to poor HIV outcomes such that only 57% of people living with HIV have achieved the goal of viral suppression nationally, and 50% are retained in clinical care. The programmes evaluated here aimed to increase HIV appointment attendance, retention in care, viral suppression and decrease acute care utilization and mitigate social needs via hospital-to-community transitional support. DESIGN A retrospective observational cohort study. METHODS We conducted a retrospective patient chart review abstracting data over three time periods between 2017 and 2020 to conduct this longitudinal programme evaluation. RESULTS Both programmes had meaningful effects on increasing HIV appointment attendance and viral suppression; Linkage to Care Plus experienced the largest gains. Older age was associated with viral suppression, and housing insecurity and mental health conditions were associated with increased emergency department utilization. CONCLUSION Hospital-only and nurse-led hospital-to-community transitional care programmes can positively influence HIV care outcomes. There is a need for enhanced attention and accountability related to health-related social needs, especially housing, and mental and behavioural health, to end the HIV epidemic. IMPACT Globally, we are striving to end the HIV epidemic with evidence-informed interventions. The nurse-led hospital-to-community and the hospital-only interventions evaluated here improved HIV outcomes with most gains realized by the nurse-led transitional care model. Integrating lessons from these programmes, with increased attention and accountability for addressing social needs, can improve practice and policies to achieve programmatic and national goals related to HIV and other diseases, and more critically, to meet the goals of the people we serve. PATIENT OR PUBLIC CONTRIBUTION Patients, staff and leadership at the University of Maryland Institute of Human Virology JACQUES Initiative and University of Maryland Medical Center THRIVE clinic contributed to the design and implementation of the programmes and informed the programme evaluation study.
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Affiliation(s)
- Marik Moen
- School of Nursing University of Maryland Baltimore Baltimore Maryland USA
| | - Megan Doede
- School of Nursing University of Maryland Baltimore Baltimore Maryland USA
| | - Meg Johantgen
- School of Nursing University of Maryland Baltimore Baltimore Maryland USA
| | - Deborah Taber
- School of Nursing University of Maryland Baltimore Baltimore Maryland USA
| | - Ikmat Adesanya
- School of Nursing University of Maryland Baltimore Baltimore Maryland USA
| | - Emily Werthman
- School of Nursing University of Maryland Baltimore Baltimore Maryland USA
| | - Erika Friedmann
- School of Nursing University of Maryland Baltimore Baltimore Maryland USA
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Friedmann E, Gee N, Simonsick E, Barr E, Resnick B, Werthman E, Adesanya I. Pet Ownership and Longitudinal Change in Physical Function: Evidence From the BLSA. Innov Aging 2021. [PMCID: PMC8682664 DOI: 10.1093/geroni/igab046.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Successful aging depends on avoiding disease and disability, maintaining high physical and cognitive function, and psychological adaptation. Research examining the relationship of pet ownership (PO) or human-animal interaction (HAI) to human health supports contributions to these successful ag-ing-related outcomes at some point in the life-cycle, mostly in populations with diseases or disabili-ties. We examine the contributions of PO to maintaining physical capacity among generally healthy community-dwelling older participants in the Baltimore Longitudinal Study of Aging (BLSA). Partici-pants’ [N=637, mean age=68.3 years (SD=9.6), pet owners N=149] completed a standardized physi-cal function test battery (among other measures) every 1-4 years and a ten-year PO history. Linear mixed, or generalized linear mixed, models with time varying PO were used to examine change in successful aging-related outcomes over up to 13 years [mean=7.5, (SD=3.6)] according to PO. Physi-cal function declined across all domains examined, but was observed to be less severe with PO in overall physical performance (p<0.001), rapid gait speed (p=0.041), 400-meter walk time (p<0.001), and reported physical wellbeing (p=0.032). No differences were observed for grip strength (p=0.56), usual gait speed (p=0.07), and leisure time physical activity (p=0.26) after con-trolling for age. This study provides the first longitudinal evidence that PO may promote successful aging among community-dwelling healthy older adults by moderating age-related declines in physical functional status in late-life.
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Affiliation(s)
| | - Nancy Gee
- Virginia Commonwealth University, Richmond, Virginia, United States
| | | | - Erik Barr
- University of Maryland Baltimore, University of Maryland Baltimore, Maryland, United States
| | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, Maryland, United States
| | - Emily Werthman
- University of Maryland, Baltimore, Baltimore, Maryland, United States
| | - Ikmat Adesanya
- University of Maryland, Baltimore, Maryland, United States
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Carr D, Friedmann E, Gee NR, Gilchrist C, Sachs-Ericsson N, Koodaly L. Dog Walking and the Social Impact of the COVID-19 Pandemic on Loneliness in Older Adults. Animals (Basel) 2021; 11:1852. [PMID: 34206286 PMCID: PMC8300215 DOI: 10.3390/ani11071852] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/16/2022] Open
Abstract
Pet ownership can provide important companionship and facilitate social connections, which may be particularly important to socially isolated older adults. Given the significant deleterious impact of loneliness on health and wellbeing in later life, many predicted that public safety measures imposed during the COVID-19 pandemic would greatly increase loneliness, particularly among vulnerable populations like older adults. We investigated whether dog walking buffers loneliness in the context of stressors imposed by the COVID-19 pandemic. Longitudinal survey data were obtained from a Florida community-based sample of adults (n = 466) aged 60+ years old in September 2018 and October 2020. Using OLS regression models, we tested: a) the association between the social consequences of COVID-19 and changes in loneliness, and b) the buffering effect of dog walking on this relationship. The high social consequences of COVID-19 were related to increases in loneliness. Walking a dog daily buffered the relationship. These results suggest potential therapeutic effects of dog walking for the promotion of mental health in older adults, particularly in the context of stressful situations that accentuate risks for loneliness.
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Affiliation(s)
- Dawn Carr
- Department of Sociology, Florida State University, Tallahassee, FL 32306, USA
| | - Erika Friedmann
- School of Nursing, University of Maryland, Baltimore, MD 21201, USA; (E.F.); (L.K.)
| | - Nancy R. Gee
- Center for Human-Animal Interaction, School of Medicine, Virginia Commonwealth University, Richmond, VA 23284, USA;
| | | | | | - Lincy Koodaly
- School of Nursing, University of Maryland, Baltimore, MD 21201, USA; (E.F.); (L.K.)
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Moen M, Storr C, German D, Friedmann E, Johantgen M. A Review of Tools to Screen for Social Determinants of Health in the United States: A Practice Brief. Popul Health Manag 2020; 23:422-429. [PMID: 31910355 PMCID: PMC7864106 DOI: 10.1089/pop.2019.0158] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Increasingly, health care institutions are called on to address social determinants of health (SDH) given the connection to morbidity and mortality across populations. However, widespread implementation of screening for health-related social conditions (HRSC) is lagging. It is estimated that half of patients who have such needs may be missed by failure to screen routinely. Health care institutions face gaps in information related to screening tools. A review of tools that screen for HRSC at the individual level is needed to share readily available and applicable tools for integration in various settings, to communicate how tools are typically administered, and to assess whether tools capture domains corresponding with Institute of Medicine (IOM) core measures. To address these gaps, an unsystematic rapid review of the literature was conducted. In addition to peer-reviewed literature, Google, PubMed, and CINAHL databases and grey literature were searched with a focus on lead agencies or scholars in the field. English language publications from 2008-2018 with content related to SDH or health-related social condition screening tools were included. Nine commonly applied tools were selected and reviewed for content, setting, and method of administration. Fifteen common domains were identified and assessed for alignment with IOM recommendations and correspondence with the construct of social stability. This review consolidates essential information about HRSC screening tools in 1 place and provides practice, policy, and research recommendations to improve HRSC screening. This review is a practice brief that can help health care institutions and clinicians implement screening and interventions related to HRSC.
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Affiliation(s)
- Marik Moen
- Family Community Health, University of Maryland Baltimore School of Nursing, Baltimore, Maryland, USA
| | - Carla Storr
- Family Community Health, University of Maryland Baltimore School of Nursing, Baltimore, Maryland, USA
| | - Danielle German
- Health, Behavior and Society, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Erika Friedmann
- Organizational Systems and Adult Health, University of Maryland Baltimore School of Nursing, Baltimore, Maryland, USA
| | - Meg Johantgen
- Organizational Systems and Adult Health, University of Maryland Baltimore School of Nursing, Baltimore, Maryland, USA
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Gilden R, Friedmann E, Holmes K, Yolton K, Xu Y, Lanphear B, Chen A, Braun J, Spanier A. Gestational Pesticide Exposure and Child Respiratory Health. Int J Environ Res Public Health 2020; 17:E7165. [PMID: 33007939 PMCID: PMC7579149 DOI: 10.3390/ijerph17197165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/21/2020] [Accepted: 09/24/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Childhood wheeze may be related to pesticide exposure, and diet and genetics (Paroxonase; PON1) may modify the effects of exposure. METHODS We analyzed data from the HOME Study, a prospective pregnancy and birth cohort, to examine the association of gestational urinary organophosphate (OP) and pyrethroid (3PBA) metabolite concentrations with child wheeze, forced expiratory volume in one second (FEV1) at ages 4 and 5 years, and wheeze trajectory patterns through age 8 years. RESULTS Among 367 singletons, the frequency of wheeze ranged from 10.6% to 24.1% at each measurement age. OP and 3PBA metabolite concentrations were not associated with wheeze at 8 years or from birth to 8 years, but there were three significant interactions: (1) maternal daily fruit and vegetable consumption (less than daily consumption and increasing 3PBA was associated with wheeze at age 8 years, OR = 1.40), (2) maternal PON1-108 allele (CT/TT genotypes and high DE was associated with wheeze at age 8 years, OR = 2.13, 2.74) and (3) PON1192 alleles (QR/RR genotypes with higher diethylphosphate (DE) and dialkyl phosphate (DAP) were associated with wheeze at age 8 years, OR = 3.84). Pesticide metabolites were not consistently related to FEV1 or wheeze trajectory. CONCLUSIONS Gestational OP and 3PBA metabolites were associated with child respiratory outcomes in participants with maternal dietary and genetic susceptibility.
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Affiliation(s)
- Robyn Gilden
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA
| | - Erika Friedmann
- Office of Research and Scholarship, University of Maryland School of Nursing, Baltimore, MD 21201, USA; (E.F.); (K.H.)
| | - Katie Holmes
- Office of Research and Scholarship, University of Maryland School of Nursing, Baltimore, MD 21201, USA; (E.F.); (K.H.)
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (K.Y.); (Y.X.)
| | - Yingying Xu
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (K.Y.); (Y.X.)
| | - Bruce Lanphear
- Department of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada;
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA;
| | - Joseph Braun
- Department of Epidemiology, Brown University, Providence, RI 02912, USA;
| | - Adam Spanier
- Department of Pediatrics, Division of General Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
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Friedmann E, Gee NR, Simonsick EM, Studenski S, Resnick B, Barr E, Kitner-Triolo M, Hackney A. Pet Ownership Patterns and Successful Aging Outcomes in Community Dwelling Older Adults. Front Vet Sci 2020; 7:293. [PMID: 32671105 PMCID: PMC7330097 DOI: 10.3389/fvets.2020.00293] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/29/2020] [Indexed: 01/19/2023] Open
Abstract
Introduction: Diminishing cognitive and physical functions, worsening psychological symptoms, and increased mortality risk and morbidity typically accompany aging. The aging population's health needs will continue to increase as the proportion of the population aged > 50 years increases. Pet ownership (PO) has been linked to better health outcomes in older adults, particularly those with chronic conditions. Much of the evidence is weak. Little is known about PO patterns as people age or the contribution of PO to successful aging in community-dwelling older adults. This study examines PO patterns among healthy community-dwelling older adults and the relationship of PO to cognitive and physical functions and psychological status. Methods: Participants in the Baltimore Longitudinal Study of Aging (> 50 years old, N = 378) completed a battery of cognitive, physical function, and psychological tests, as well as a PO questionnaire. Descriptive and non-parametric or general/generalized linear model analyses were conducted for separate outcomes. Results: Most participants (82%) had kept pets and 24% have pets: 14% dogs, 12% cats, 3% other pets. The most frequent reasons for having pets included enjoyment (80%) and companionship (66%). Most owners had kept the pet they had the longest for over 10 years (70%). PO was lower in older decades (p < 0.001). Pet owners were more likely to live in single-family homes and reside with others (p = 0.001) than non-owners. Controlling for age, PO was associated independently with better cognitive function (verbal leaning/memory p = 0.041), dog ownership predicted better physical function (daily energy expenditure, p = 0.018), and cat ownership predicted better cognitive functioning (verbal learning/memory, p = 0.035). Many older adults who did not own pets (37%) had regular contact with pets, which was also related to health outcomes. Conclusion: PO is lower at older ages, which mirrors the general pattern of poorer cognitive and physical function, and psychological status at older ages. PO and regular contact with pets (including PO) are associated with better cognitive status compared with those who did not own pets or had no regular contact with pets independent of age. Dog ownership was related to better physical function. Longitudinal analysis is required to evaluate the association of PO and/or regular contact with maintenance of health status over time.
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Affiliation(s)
- Erika Friedmann
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, United States
| | - Nancy R Gee
- Center for Human Animal Interaction, Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Stephanie Studenski
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Barbara Resnick
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, United States
| | - Erik Barr
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, United States
| | - Melissa Kitner-Triolo
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Alisha Hackney
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, United States
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Friedmann E, Gee NR. Critical Review of Research Methods Used to Consider the Impact of Human-Animal Interaction on Older Adults' Health. Gerontologist 2020; 59:964-972. [PMID: 29668896 DOI: 10.1093/geront/gnx150] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Most research on human-animal interaction (HAI) and human health focuses on one of three perspectives: (a) health effects of pet ownership; (b) health effects of contact with a companion animal; or (c) health effects of animal-assisted interventions including animal-assisted therapies, and animal-assisted activities. METHODS We reviewed research methods used to address each perspective, within the context of human aging, and identified challenges associated with these methods. RESULTS The complex challenges involved in designing studies to address all three perspectives and examples of research design elements that can be used to alleviate issues raised in each type of study are provided. DISCUSSION AND IMPLICATIONS We suggest emerging methodologies that may be helpful for answering important questions from all three perspectives about the relationship of HAI to health outcomes for older adults.
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Affiliation(s)
| | - Nancy R Gee
- State University of New York, Fredonia & WALTHAM Centre for Pet Nutrition
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Turkeltaub PC, Lockey RF, Holmes K, Friedmann E. Asthma and/or hay fever as predictors of fertility/impaired fecundity in U.S. women: National Survey of Family Growth. Sci Rep 2019; 9:18711. [PMID: 31822754 PMCID: PMC6904488 DOI: 10.1038/s41598-019-55259-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 11/26/2019] [Indexed: 01/25/2023] Open
Abstract
This study addresses whether asthma and/or hay fever predict fertility and impaired fecundity. The lifetime number of pregnancies (fertility) and spontaneous pregnancy losses (impaired fecundity) in 10,847 women representative of the U.S. population 15 to 44 years of age with histories of diagnosed asthma and/or hay fever are analyzed in the 1995 National Survey of Family Growth using multivariable Poisson regression with multiple covariates and adjustments for complex sampling. Smokers have significantly increased fertility compared to nonsmokers. Smokers with asthma only have significantly increased fertility compared to other smokers. Higher fertility is associated with impaired fecundity (ectopic pregnancy, miscarriage, stillbirth). Women with asthma (with and without hay fever) have significantly higher pregnancy losses than women without asthma. With increasing number of pregnancies, smokers have increased pregnancy losses compared to nonsmokers. Smokers, especially those with asthma only, have increased fertility and require special attention as to their family planning needs, reproductive health, and smoking cessation. Women with asthma, regardless of number of pregnancies, and smokers with higher numbers of pregnancies have high risk pregnancies that require optimal asthma/medical management prenatally and throughout pregnancy. Whether a proinflammatory asthma endotype underlies both the increased fertility and impaired fecundity associated with age and smoking is discussed.
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Affiliation(s)
| | - Richard F Lockey
- Division of Allergy & Immunology, University of South Florida College of Medicine, 13000 Bruce B. Downs Blvd, Tampa, Florida, 33613, USA
| | - Katie Holmes
- Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Baltimore, Maryland, 21201, USA
- The Hilltop Institute, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, Maryland, 21250, USA
| | - Erika Friedmann
- Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Baltimore, Maryland, 21201, USA
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12
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Hackney A, Friedmann E. OLDER ADULT PET OWNERSHIP HISTORY, MARITAL STATUS, AND HEALTH OUTCOMES: THE WISCONSIN LONGITUDINAL STUDY (WLS). Innov Aging 2019. [PMCID: PMC6844859 DOI: 10.1093/geroni/igz038.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We explore the association of PO and marital status to changes in health during aging. This secondary analysis uses 1992, 2004, and 2011 data from healthy participants (N=2,319) in the WLS. Health outcomes (symptoms, illnesses, days in bed due to illness, depression, and cognition) and demographic/ health variables (age, marital status, sex, smoking, BMI, engagement with friends/relatives). PO (ever owned a pet/dog/cat) was assessed in 2011. In linear mixed models, PO, dog ownership, and cat ownership (CO) independently predicted changes in health outcomes. Marital status moderated the association of CO to changes in cognition[F(1,012.85)=4.09,p=0.043]. Both marriage and CO were associated with increased cognition from ages 53 to 64; being unmarried without CO was associated with reduced cognition during aging with the lowest cognition by age 70. Results provide insight into how PO and social support influence healthy aging. Longitudinal PO and health/social data are necessary to better understand these relationships.
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Affiliation(s)
- Alisha Hackney
- University of Maryland School of Nursing, Baltimore, Maryland, United States
| | - Erika Friedmann
- University of Maryland School of Nursing, Baltimore, Maryland, United States
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13
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Friedmann E, Gee NR, Simonsick EM, Studenski S, Barr E, Resnick B, Kitner-Triolo MH, Hackney A. PET OWNERSHIP HISTORY AND SUCCESSFUL AGING OUTCOMES IN COMMUNITY-LIVING OLDER ADULTS. Innov Aging 2019. [PMCID: PMC6840391 DOI: 10.1093/geroni/igz038.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Diminishing cognitive and physical function, worsening psychological symptoms and increased mortality risk and morbidity typically accompany aging. Health needs of the aging population will continue to increase as the proportion of the population aged 50 years and older increases. Pet ownership (PO) has been linked to better health outcomes in older adults, particularly those with chronic health conditions. However, much of the evidence is weak with little known about the contribution of PO to successful aging in community living older adults. This study examines associations between PO and cognitive performance, physical functioning, and psychological status in community living older adults. Participants in the Baltimore Longitudinal Study of Aging (>50 years old, N=378) completed physical functioning, cognitive and psychological testing, and a ten-year PO history. Most participants (89%) had owned pets at some point and 24% currently have pets. Fourteen percent have 1-4 dogs, 12% have 1-4 cats, and 3% have others. PO was lower with older age (p<.001). In regression analysis controlling for age decade, pet ownership within the past 10 years (PO10) independently predicted cognitive function [total verbal learning (p=.04), and short (p=.015) and long (p=.031) delay free recall, ] but not physical function or psychological status. PO was lower in older age groups as was cognitive, physical functional, and psychological status, while PO within the past 10 years was associated with better verbal learning and memory independent of age. Longitudinal analysis is required to disentangle the sequential associations between PO and change in health status over time..
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Affiliation(s)
- Erika Friedmann
- University of Maryland School of Nursing, Baltimore, Maryland, United States
| | | | - Eleanor M Simonsick
- Longitudinal Studies Section, Intramural Research Program, National Institute on Aging, Baltimore, Maryland, United States
| | | | - Erik Barr
- University of Maryland School of Nursing, Baltimore, Maryland, United States
| | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, Maryland, United States
| | | | - Alisha Hackney
- University of Maryland School of Nursing, Baltimore, Maryland, United States
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14
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Krause-Parello CA, Friedmann E, Wilson C, Hatzfeld JJ, Kolassa J, Hackney A, Morales KA. Relation of post-traumatic stress disorder symptom severity to the efficacy of an animal-assisted intervention for stress reduction after military aeromedical evacuation. Stress Health 2019; 35:480-490. [PMID: 31274219 DOI: 10.1002/smi.2881] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 06/13/2019] [Accepted: 06/14/2019] [Indexed: 11/08/2022]
Abstract
Animal-assisted interventions (AAIs) have been found to decrease stress in some settings, but it is not known if AAI is feasible in an aeromedical staging facility or effective in reducing stress following aeromedical evacuation (AE) of military personnel. An experimental design was used to evaluate the efficacy of AAI at reducing stress in AE military patients (N = 120). Patients participated in a 20-min AAI (n = 60) or 20-min informational session about assistance dogs as an attention-control group (n = 60). Demographics, post-traumatic stress symptom severity (PTSSS), and stress biomarkers (cortisol, alpha-amylase, and immunoglobulin A) were collected regular intervals. AAI was found feasible and efficacious at reducing stress. Cortisol decreased significantly (p < .05) in the AAI group compared with the attention-control group. PTSSS moderated the immunoglobulin A responses to AAI as demonstrated by the interaction of PTSD Checklist-Military Version score, group, and time, F(1, 111.23) = 4.15 p = .044; effect size: d = 0.31. This research supports AAI as a stress-reducing modality in AE patients, particularly those who report higher PTSSS. Implications for future research are discussed.
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Affiliation(s)
- Cheryl A Krause-Parello
- Florida Atlantic University, Christine E. Lynn College of Nursing, Canines Providing Assistance to Wounded Warriors (C-P.A.W.W.), Boca Raton, Florida, United States
| | - Erika Friedmann
- Office of Research and Scholarship, University of Maryland School of Nursing, Baltimore, Maryland, United States
| | - Candy Wilson
- Daniel K. Inouye Graduate School of Nursing, Uniformed Services University, Bethesda, Maryland, United States
| | - Jennifer J Hatzfeld
- TriService Nursing Research Program, Uniformed Services University, Bethesda, Maryland, United States
| | - John Kolassa
- Department of Statistics, Rutgers, The State University of New Jersey, Piscataway, New Jersey, United States
| | - Alisha Hackney
- Office of Research and Scholarship, University of Maryland School of Nursing, Baltimore, Maryland, United States
| | - Kristie A Morales
- School of Professional Psychology, Spalding University, Louisville, Kentucky, United States.,Canines Providing Assistance to Wounded Warriors (C-P.A.W.W.), United States
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15
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Gee NR, Reed T, Whiting A, Friedmann E, Snellgrove D, Sloman KA. Observing Live Fish Improves Perceptions of Mood, Relaxation and Anxiety, But Does Not Consistently Alter Heart Rate or Heart Rate Variability. Int J Environ Res Public Health 2019; 16:ijerph16173113. [PMID: 31461881 PMCID: PMC6747257 DOI: 10.3390/ijerph16173113] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 11/18/2022]
Abstract
Although fish and other aquatic species are popular privately-kept pets, little is known about the effects of watching live fish on the perceptions of arousal and the link between those perceptions and physiological measures of arousal. In two separate experiments, participants were asked to watch identically-equipped fish tanks for five minutes in each of three conditions: (1) Live fish, (2) plants and water, and (3) empty tank. Linear mixed models used across both experiments revealed similar results: Greater perceptions of relaxation and mood, and less anxiety during or after viewing the live fish condition, compared with the other conditions. Heart rate and heart rate variability responded to the arousal associated with a math task, but did not differ consistently across viewing conditions. These results suggest that the link between perceptions of arousal, and the physiological measures associated with arousal, may not be strong or immediate, or that heart rate and heart rate variability may not be appropriate measures for the test population. Implications of these results for the biophilia hypothesis and the biopsychosocial model are discussed.
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Affiliation(s)
- Nancy R Gee
- Department of Psychology, State University of New York, Fredonia, NY 14063, USA.
- WALTHAM Centre for Pet Nutrition, Leicestershire LE14 4RT, UK.
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0710, USA.
| | - Taylor Reed
- Department of Psychology, State University of New York, Fredonia, NY 14063, USA
| | - April Whiting
- Department of Psychology, State University of New York, Fredonia, NY 14063, USA
| | - Erika Friedmann
- School of Nursing, University of Maryland, Baltimore, MD 21201, USA
| | | | - Katherine A Sloman
- Institute of Biomedical and Environmental Health Research, School of Health and Life Sciences, University of the West of Scotland, Paisley PA1 2BE, UK
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16
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Rawlett KE, Friedmann E, Thomas SA. Mindfulness based intervention with an attentional comparison group in at risk young adolescents: a pilot randomized controlled trial. Integr Med Res 2019; 8:101-106. [PMID: 31193363 PMCID: PMC6527909 DOI: 10.1016/j.imr.2019.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Risky behaviors are related to poor outcomes among young adolescents. This study piloted a mindfulness based intervention, Learning 2 Breath Mindfulness Curriculum, focusing on the feasibility of programming and intervention effects on coping, affect, and trait mindfulness among at-risk adolescents. Further, the mindfulness based intervention was compared to an attention intervention. METHODS Sixth-grade level female students in a boarding school for at-risk youth randomly allocated to either the mindfulness intervention (n = 12) or an attention intervention (n = 11) for six weeks. Outcomes (i.e., primary coping, positive affect, and trait mindfulness) were assessed before and after the interventions. RESULTS Intervention groups did not differ in demographics or outcomes at baseline. Twenty-two of 23 (95.7%) registered participants attended all of the sessions. Participants completed 86.4% of study tools. Separate repeated measures ANOVAs revealed no significant interactions among group and time for primary coping, positive affect, or mindfulness. However, positive affect did increase [F(1, 17) = 10.675, p = 0.005, partial η 2 = 0.39] over time for both groups and there was a slight increase in trait mindfulness over time (although not statistically significant; p = 0.095, partial η 2 = 0.155]). Primary coping did not change with time. CONCLUSION The mindfulness intervention utilized in the present study exhibited feasibility in this population. Although preliminary, mindfulness based interventions may contribute to positive affect among at-risk youth in a boarding school. Limitations and future directions are discussed.
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Affiliation(s)
- Kristen E. Rawlett
- Department of Family and Community Health, School of Nursing University of Maryland, Baltimore, United States
| | - Erika Friedmann
- Department of Research and Scholarship, School of Nursing University of Maryland, Baltimore, United States
| | - Sue A. Thomas
- Professor Emeritus, School of Nursing University of Maryland, Baltimore, United States
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17
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Affiliation(s)
| | - N Gee
- . WALTHAM & SUNY, Fredonia
| | - E Simonsick
- National Institute on Aging Intramural Research Program
| | - S Studenski
- National Institute on Aging, National Institutes of Health
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18
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Friedmann E, Galik B, Gee N. THE PET ASSISTED LIVING (PAL) INTERVENTION FOR ASSISTED LIVING RESIDENTS WITH COGNITIVE IMPAIRMENT. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - B. Galik
- University of Maryland, Baltimore, Maryland,
| | - N.R. Gee
- Psychology, SUNY, Fredonia, Fredonia, New York,
- WALTHAM, Waltham on the Wolds, United Kingdom
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19
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Turkeltaub PC, Cheon J, Friedmann E, Lockey RF. The Influence of Asthma and/or Hay Fever on Pregnancy: Data from the 1995 National Survey of Family Growth. J Allergy Clin Immunol Pract 2017; 5:1679-1690. [PMID: 28550983 DOI: 10.1016/j.jaip.2017.03.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 03/19/2017] [Accepted: 03/31/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND Asthma is associated with adverse pregnancy outcomes. At the same time there is a worldwide increase in asthma and hay fever. OBJECTIVE This study addresses whether asthma and/or hay fever adversely influence pregnancy outcomes. METHODS Data from the 1995 National Survey of Family Growth that include a history of diagnosed asthma, hay fever, and adverse pregnancy outcomes in 10,847 women representative of the US population aged 15 to 44 years were analyzed. RESULTS Women with the allergic phenotypes asthma and hay fever and hay fever only had no significant increase in adverse pregnancy outcomes (spontaneous pregnancy loss, preterm birth, infant low birth weight), whereas women with the nonatopic phenotype asthma only (without hay fever) did. The study did not evaluate endotypes. CONCLUSIONS This study provides new data that the allergic phenotypes, asthma and hay fever and hay fever only, are compatible with healthy pregnancy, whereas the nonatopic asthma phenotype, asthma only, adversely impacts pregnancy.
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Affiliation(s)
| | - Jooyoung Cheon
- Sungshin Women's University College of Nursing, Seoul, Korea
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20
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Park BK, Nahm ES, Rogers VE, Choi M, Friedmann E, Wilson M, Koru G. A Facebook-Based Obesity Prevention Program for Korean American Adolescents: Usability Evaluation. J Pediatr Health Care 2017; 31:57-66. [PMID: 26952300 DOI: 10.1016/j.pedhc.2016.02.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 02/07/2016] [Accepted: 02/08/2016] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Adolescent obesity is one of the most serious global public health challenges. Social networking sites are currently popular among adolescents. Therefore, the obesity prevention program for Korean American adolescents was developed on the most popular social networking site, Facebook. The purpose of this study was to evaluate the usability of a culturally tailored Facebook-based obesity prevention program for Korean American adolescents (Healthy Teens). METHOD An explorative descriptive design of usability testing was used. Usability testing employing one-on-one observation, the think-aloud method, audio taping, screen activity capture, and surveys was performed. Twenty participants were recruited from two Korean language schools (mean age, 15.40 ± 1.50 years). Recruitment and user testing was performed between February and April 2014. Content analysis, using the inductive coding approach, was performed by three coders to analyze transcriptions. Descriptive statistics were used to analyze quantitative data including demographic characteristics, perceived usability, eHealth literacy, and health behaviors. RESULTS Testing revealed several usability issues in content, appearance, and navigation. Participants' comments regarding content were positive. Although the Facebook platform provided limited flexibility with respect to building the site, participants described the program's appearance as appropriate. Most participants did not experience difficulty in navigating the program. DISCUSSION Our preliminary findings indicated that participants perceived the Healthy Teens program as usable and useful. This program could be used as a robust platform for the delivery of health education to adolescents. Further research is required to assess the effects of Facebook-based programs on adolescent obesity prevention.
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21
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Son H, Friedmann E, Thomas SA, Son YJ. Biopsychosocial predictors of coping strategies of patients postmyocardial infarction. Int J Nurs Pract 2016; 22:493-502. [PMID: 27492735 DOI: 10.1111/ijn.12465] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 04/21/2016] [Accepted: 06/12/2016] [Indexed: 11/29/2022]
Abstract
Data from the Patients and Families Psychological Response to the Home Automated External Defibrillator Trial were used to examine the relationship between biopsychosocial variables and patients' coping strategies postmyocardial infarction. This study is the secondary data analysis of longitudinal observational study. A total of 460 patient-spouse pairs were recruited in January 2003 to October 2005. Hierarchical linear regression analysis examined biological/demographic, psychological and social variables regarding patients' coping scores using the Family Crisis Oriented Personal Evaluation Scale. Lower social support and social support satisfaction predicted lower total coping scores. Being younger, male gender and time since the myocardial infarction predicted lower positive coping strategy use. Higher anxiety and lower social support were related to fewer positive coping methods. Lower educational levels were related to increased use of negative coping strategies. Reduced social support predicted lower total coping scores and positive coping strategy use and greater passive coping style use. Social support from a broad network assisted with better coping; those living alone may need additional support. Social support and coping strategies should be taken into consideration for patients who have experienced a cardiac event.
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Affiliation(s)
- Heesook Son
- Chung-Ang University, Red Cross College of Nursing, Seoul, Korea
| | - Erika Friedmann
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Sue A Thomas
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Youn-Jung Son
- Chung-Ang University, Red Cross College of Nursing, Seoul, Korea.
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22
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Zeidan AM, Hendrick F, Friedmann E, Baer MR, Gore SD, Sasane M, Paley C, Davidoff AJ. Deferasirox therapy is associated with reduced mortality risk in a medicare population with myelodysplastic syndromes. J Comp Eff Res 2016; 4:327-40. [PMID: 26274794 DOI: 10.2217/cer.15.20] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIMS Iron overload adversely affects patients with myelodysplastic syndromes (MDS), but benefits of iron chelation therapy have not been clearly demonstrated. We examined the association between deferasirox (DFX) therapy and mortality in transfusion-receiving Medicare patients. PATIENTS & METHODS MDS patients from 2005 to 2008 were identified using ICD-9 codes from 100% Medicare claims. Patients receiving ≥20 blood units were observed until death or end of study. Marginal structural models were used for estimation. RESULTS 3926 patients (10.1% used DFX) were observed for a mean of 48.8 weeks. Each incremental week of DFX was associated with a significant reduction in mortality risk (hazard ratio [HR]: 0.989; 95% CI: 0.983-0.996; p = 0.001). CONCLUSION DFX therapy is associated with a reduced mortality risk among older MDS patients who received a minimum transfusion threshold.
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Affiliation(s)
- Amer M Zeidan
- Department of Internal Medicine, Section of Hematology, Yale University, New Haven, CT 06520, USA
| | - Franklin Hendrick
- Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
| | - Erika Friedmann
- Department of Organizational Systems & Adult Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA
| | - Maria R Baer
- Marlene & Stewart Greenebaum Cancer Center, University of Maryland, Baltimore, MD 21201, USA
| | - Steven D Gore
- Department of Internal Medicine, Section of Hematology, Yale University, New Haven, CT 06520, USA
| | - Medha Sasane
- Novartis Pharmaceuticals Corporation, East Hanover, NJ 07936, USA
| | - Carole Paley
- Novartis Pharmaceuticals Corporation, East Hanover, NJ 07936, USA
| | - Amy J Davidoff
- Department of Health Policy & Management, Yale School of Public Health, Yale University, New Haven, CT 06520, USA
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23
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Gilden R, Plisko M, Hiteshew K, Friedmann E, Milton D. Pesticide monitoring on soccer fields via shoe wipes and urine samples. Environ Res 2016; 147:294-296. [PMID: 26921825 DOI: 10.1016/j.envres.2016.02.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 02/15/2016] [Accepted: 02/17/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE We sought to determine the feasibility of measuring pesticide exposure of children using athletic fields to which pesticides were recently applied. DESIGN AND SAMPLE This project was a pilot feasibility study designed to measure pre and posttest environmental exposure to Horsepower; a combination herbicide containing (4-Chloro-2-methylphenoxy) acetic acid (MCPA), dicamba and triclopyr. A spot application of Horsepower to a soccer field occurred at 8AM. Six players, ages 5-11 years, provided shoe wipes and urine samples before and after evening soccer practice on the field later the same day. MEASUREMENTS AND RESULTS We sent samples to commercial labs where shoe wipes were analyzed for a panel of herbicides and urine samples were analyzed for dicamba, triclopyr, and creatinine. All analytes were below level of detection. CONCLUSIONS We established the feasibility of both the recruitment and sampling procedures. Spot application, in the one instance examined, did not result in measurable exposure to pesticides. A larger study involving both spot and broadcast application and including direct observation of pesticide application is needed to ascertain whether pesticide application on athletic fields results in measurable and potentially hazardous exposure of children.
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Affiliation(s)
- Robyn Gilden
- University of Maryland School of Nursing, 655W. Lombard St, Baltimore MD 21201, USA.
| | - Marc Plisko
- Environmental Profiles, Inc., 8805 Columbia 100 Parkway, Suite 100, Columbia MD 21045, USA.
| | - Kathleen Hiteshew
- Environmental Profiles, Inc., 8805 Columbia 100 Parkway, Suite 100, Columbia MD 21045, USA.
| | - Erika Friedmann
- University of Maryland School of Nursing, 655W. Lombard St, Baltimore MD 21201, USA.
| | - Donald Milton
- University of Maryland College Park, School of Public Health, 2242 Valley Drive, College Park, MS 20742, USA.
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24
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Warren JI, Montgomery KL, Friedmann E. Three-Year Pre-Post Analysis of EBP Integration in a Magnet-Designated Community Hospital. Worldviews Evid Based Nurs 2016; 13:50-8. [DOI: 10.1111/wvn.12148] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Joan Insalaco Warren
- Director of Nursing Research and Magnet; MedStar Franklin Square Medical Center; Baltimore MD
| | - Kathryn Lothschuetz Montgomery
- Associate Professor, Chair, Department of Partnerships, Professional Education, & Practice; University of Maryland School of Nursing; Baltimore MD
| | - Erika Friedmann
- Associate Dean of Research, and Professor, Organizational Systems & Adult Health; University of Maryland School of Nursing; Baltimore MD
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25
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Chung S, Zhu S, Friedmann E, Kelleher C, Kozlovsky A, Macfarlane KW, Tkaczuk KHR, Ryan AS, Griffith KA. Weight loss with mindful eating in African American women following treatment for breast cancer: a longitudinal study. Support Care Cancer 2015; 24:1875-81. [PMID: 26463645 DOI: 10.1007/s00520-015-2984-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/05/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE Women with higher body mass index (BMI) following breast cancer (BC) treatment are at higher risk of BC recurrence and death than women of normal weight. African American (AA) BC patients have the highest risk of BC recurrence and gain more weight after diagnosis than their white counterparts. The purpose of this study was to evaluate the association between a mindful eating intervention and weight loss in AA women following chemotherapy for BC. METHODS A single-group 24-week longitudinal pilot study with repeated measures was conducted. AA women (N = 22, BMI = 35.13 kg/m(2), range = 27.08-47.21) with stage I-III BC who had finished active cancer treatment received a 12-week mindful eating intervention with individual dietary counseling and group mindfulness sessions, followed by bi-weekly telephone follow-up for 12 weeks. Linear mixed models were used to evaluate the effects of the intervention and of baseline mindfulness on the weight change over time. RESULTS In the overall group (N = 22), MEQ scores increased over time (p = 0.001) while weight decreased over time (-0.887 kg, p = 0.015). Weight loss over time was associated with higher T1 MEQ scores (p = 0.043). Participants in the higher MEQ group (n = 11) at T1 experienced significant weight loss over time (-1.166 kg, p = 0.044), whereas those in the low MEQ (n = 11) did not lose weight. Participants who were diagnosed with stage 1 BC experienced significant weight loss over time (-7.909 kg, p = 0.014). CONCLUSIONS This study suggests that a mindful weight loss program may be effective for weight reduction and maintenance in some AA women who have completed treatment for BC, particularly those diagnosed with stage 1 BC and with initially higher mindful eating behaviors. Mindful weight loss program is proposed as a promising way in which to reduce obesity-related conditions in AA BC survivors.
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Affiliation(s)
- SeonYoon Chung
- University of Maryland School of Nursing, 655 W. Lombard Street, Baltimore, MD, 21201, USA.
| | - Shijun Zhu
- University of Maryland School of Nursing, 655 W. Lombard Street, Baltimore, MD, 21201, USA.
| | - Erika Friedmann
- University of Maryland School of Nursing, 655 W. Lombard Street, Baltimore, MD, 21201, USA.
| | - Catherine Kelleher
- University of Maryland School of Nursing, 655 W. Lombard Street, Baltimore, MD, 21201, USA.
| | - Adriane Kozlovsky
- Baltimore Veterans Administration Medical Center, 10 North Greene Street, Baltimore, MD, 21201, USA. .,Division of Gerontology and Geriatric Medicine, Geriatric Research, Education, and Clinical Center (GRECC), University of Maryland School of Medicine, 10 North Greene Street, Baltimore, MD, 21201, USA.
| | - Karen W Macfarlane
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, 401 North Broadway, Baltimore, MD, 21287, USA.
| | - Katherine H R Tkaczuk
- University of Maryland School of Medicine and Greenebaum Cancer Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
| | - Alice S Ryan
- Baltimore Veterans Administration Medical Center, 10 North Greene Street, Baltimore, MD, 21201, USA. .,Division of Gerontology and Geriatric Medicine, Geriatric Research, Education, and Clinical Center (GRECC), University of Maryland School of Medicine, 10 North Greene Street, Baltimore, MD, 21201, USA.
| | - Kathleen A Griffith
- University of Maryland School of Nursing, 655 W. Lombard Street, Baltimore, MD, 21201, USA.
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26
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Cutler W, Bürki R, Kolter J, Chambliss C, Friedmann E, Hart K. Invasive Breast Cancer Incidence in 2,305,427 Screened Asymptomatic Women: Estimated Long Term Outcomes during Menopause Using a Systematic Review. PLoS One 2015; 10:e0128895. [PMID: 26107183 PMCID: PMC4479875 DOI: 10.1371/journal.pone.0128895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/02/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Earlier studies of breast cancer, screening mammography, and mortality reduction may have inflated lifetime and long-term risk estimates for invasive breast cancer due to limitations in their data collection methods and interpretation. OBJECTIVE To estimate the percentage of asymptomatic peri/postmenopausal women who will be diagnosed with a first invasive breast cancer over their next 25 years of life. METHODS A systematic review identified peer-reviewed published studies that: 1) enrolled no study participants with a history of invasive breast cancer; 2) specified the number of women enrolled; 3) reported the number of women diagnosed with a first invasive breast cancer; 4) did not overcount [count a woman multiple times]; and, 5) defined the length of follow-up. Data sources included PubMed, Cochrane Library, and an annotated library of 4,409 full-text menopause-related papers collected and reviewed by the first author from 1974 through 2008. Linear regression predicted incidence of first invasive breast cancer, based on follow-up duration in all studies that met the our inclusion criteria, and in a subset of these studies that included only women who were 1) at least 50 years old and 2) either at least 50 or less than 50 but surgically menopausal at enrollment. RESULTS Nineteen studies met the inclusion criteria. They included a total of 2,305,427 peri/postmenopasual women. The mean cumulative incidence rate of first invasive breast cancer increased by 0.20% for each year of age (95% CI: 0.17, 0.23; p < 0.01; R2 = 0.90). Over 25 years of follow-up, an estimated 94.55% of women will remain breast cancer-free (95% CI: 93.97, 95.13). In the 12 studies (n = 1,711,178) that enrolled only postmenopausal women, an estimated 0.23% of women will be diagnosed with a first invasive breast cancer each year (95% CI: 0.18, 0.28; p < 0.01, R2 = 0.88). CONCLUSION The vast majority (99.75%) of screened asymptomatic peri/postmenopasual women will not be diagnosed with invasive breast cancer each year. Approximately 95% will not be diagnosed with invasive breast cancer during 25 years of follow-up. Women who receive clinical examinations, but do not have mammograms, will have higher cancer-free rates because innocuous positives (comprising 30-50% of mammography diagnoses) will remain undetected. Informed consent to asymptomatic women should include these results and consideration of the benefits of avoiding mammograms.
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Affiliation(s)
- Winnifred Cutler
- Department of Women’s Health Research, Athena Institute for Women’s Wellness, Chester Springs, Pennsylvania, United States of America
| | - Regula Bürki
- Department of Gynecology, Hirslanden Hospital Group, Bern, Switzerland
| | - James Kolter
- Department of Obstetrics and Gynecology, The Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States of America
- Department of Obstetrics and Gynecology, Paoli Hospital, Paoli, Pennsylvania, United States of America
| | - Catherine Chambliss
- Department of Psychology, Ursinus College, Collegeville, Pennsylvania, United States of America
| | - Erika Friedmann
- School of Nursing, University of Maryland, Baltimore, Maryland, United States of America
| | - Kari Hart
- Department of Mathematics and Computer, The Hotchkiss School, Lakeville, Connecticut, United States of America
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Friedmann E, Galik E, Thomas SA, Hall PS, Chung SY, McCune S. Evaluation of a pet-assisted living intervention for improving functional status in assisted living residents with mild to moderate cognitive impairment: a pilot study. Am J Alzheimers Dis Other Demen 2015; 30:276-89. [PMID: 25118333 PMCID: PMC10852909 DOI: 10.1177/1533317514545477] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
BACKGROUND In older adults with cognitive impairment (CI), decreased functional status and increased behavioral symptoms require relocation from assisted living (AL) to nursing homes. Studies support positive effects of pets on health/function. PURPOSE Evaluate the effectiveness of the Pet AL (PAL) intervention to support physical, behavioral, and emotional function in AL residents with CI. METHODS Cognitively impaired AL residents randomized to 60-90 minute sessions [PAL (n = 22) or reminiscing (n = 18)] twice/week for 12 weeks. PAL interventionist encourages residents to perform skills with the visiting dog; reminiscing interventionist encourages residents to reminisce. Monthly assessment of physical (energy expenditure, activities of daily living), emotional (depression, apathy), and behavioral (agitation) function. RESULTS In linear mixed models, physical activity depressive symptoms improved more with PAL. CONCLUSION Evidence supports that the PAL program helps preserve/enhance function of AL residents with CI. Additional study is required to evaluate the duration and predictors of effectiveness of the PAL intervention.
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Affiliation(s)
- Erika Friedmann
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Elizabeth Galik
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Sue A Thomas
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - P Sue Hall
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Seon Yoon Chung
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Sandra McCune
- WALTHAM Centre for Pet Nutrition, Leicestershire, United Kingdom
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Banankhah SK, Friedmann E, Thomas S. Effective treatment of depression improves post-myocardial infarction survival. World J Cardiol 2015; 7:215-223. [PMID: 25914790 PMCID: PMC4404376 DOI: 10.4330/wjc.v7.i4.215] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 01/05/2015] [Accepted: 02/09/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To examine the contribution of treatment resistant depression (TRD) to mortality in depressed post-myocardial infarction (MI) patients independent of biological and social predictors.
METHODS: This secondary analysis study utilizes the Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial data. From 1834 depressed patients in the ENRICHD study, there were 770 depressed post-MI patients who were treated for depression. In this study, TRD is defined as having a less than 50% reduction in Hamilton Depression (HAM-D) score from baseline and a HAM-D score of greater than 10 in 6 mo after depression treatment began. Cox regression analysis was used to examine the independent contributions of TRD to mortality after controlling for the biological and social predictors.
RESULTS: TRD occurred in 13.4% (n = 103) of the 770 patients treated for depression. Patients with TRD were significantly younger in age (P = 0.04) (mean = 57.0 years, SD = 11.7) than those without TRD (mean = 59.2 years, SD = 12.0). There was a significantly higher percentage of females with TRD (57.3%) compared to females without TRD (47.4%) [χ2 (1) = 4.65, P = 0.031]. There were significantly more current smokers with TRD (44.7%) than without TRD (33.0%) [χ2 (1) = 7.34, P = 0.007]. There were no significant differences in diabetes (P = 0.120), history of heart failure (P = 0.258), prior MI (P = 0.524), and prior stroke (P = 0.180) between patients with TRD and those without TRD. Mortality was 13% (n = 13) in patients with TRD and 7% (n = 49) in patients without TRD, with a mean follow-up of 29 mo (18 mo minimum and maximum of 4.5 years). TRD was a significant independent predictor of mortality (HR = 1.995; 95%CI: 1.011-3.938, P = 0.046) after controlling for age (HR = 1.036; 95%CI: 1.011-1.061, P = 0.004), diabetes (HR = 2.912; 95%CI: 1.638-5.180, P < 0.001), heart failure (HR = 2.736; 95%CI: 1.551-4.827, P = 0.001), and smoking (HR = 0.502; 95%CI: 0.228-1.105, P = 0.087).
CONCLUSION: The analysis of TRD in the ENRICHD study shows that the effective treatment of depression reduced mortality in depressed post-MI patients. It is important to monitor the effectiveness of depression treatment and change treatments if necessary to reduce depression and improve cardiac outcomes in depressed post-MI patients.
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Lee MC, Hinderer KA, Friedmann E. Engaging Chinese American Adults in Advance Care Planning: A Community-Based, Culturally Sensitive Seminar. J Gerontol Nurs 2015; 41:17-21. [PMID: 25912237 DOI: 10.3928/00989134-20150406-01] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 01/26/2015] [Indexed: 11/20/2022]
Abstract
Ethnic minority groups are less engaged than Caucasian American adults in advance care planning (ACP). Knowledge deficits, language, and culture are barriers to ACP. Limited research exists on ACP and advance directives in the Chinese American adult population. Using a pre-posttest, repeated measures design, the current study explored the effectiveness of a nurseled, culturally sensitive ACP seminar for Chinese American adults on (a) knowledge, completion, and discussion of advance directives; and (b) the relationship between demographic variables, advance directive completion, and ACP discussions. A convenience sample of 72 urban, community-dwelling Chinese American adults (mean age=61 years) was included. Knowledge, advance directive completion, and ACP discussions increased significantly after attending the nurse-led seminar (p<0.01). Increased age correlated with advance directive completion and ACP discussions; female gender correlated with ACP discussions. Nursing education in a community setting increased advance directive knowledge and ACP engagement in Chinese American adults.
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Freedenberg VA, Thomas SA, Friedmann E. A pilot study of a mindfulness based stress reduction program in adolescents with implantable cardioverter defibrillators or pacemakers. Pediatr Cardiol 2015; 36:786-95. [PMID: 25519914 DOI: 10.1007/s00246-014-1081-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/05/2014] [Indexed: 11/25/2022]
Abstract
Adolescents with implantable cardioverter defibrillators (ICDs) or pacemakers (PMs) face unique challenges that can cause psychosocial distress. Psychosocial interventions are effective for adults with cardiac devices and could potentially impact adolescents' adjustment to these devices. Mindfulness Based Stress Reduction (MBSR) is a structured psycho-educational program that includes meditation, yoga, and group support and has been studied extensively among adults. This study examined the feasibility of the MBSR program for adolescents with ICDs/PMs, a population previously unexamined in the research literature. The participants completed measures of anxiety and depression (Hospital Anxiety and Depression Scale) and coping (Responses to Stress Questionnaire) at baseline and after the six-session MBSR intervention. Mean age of the cohort (n = 10) was 15 ± 3 years, 6 were male, 6 had a PM, and 4 had an ICD. Feasibility was demonstrated by successful recruitment of 10 participants, 100 % participation and completion. Anxiety decreased significantly following the intervention, with a large effect size, t[9] = 3.67, p < .01, ŋ (2) = .59. Anxiety frequency decreased from baseline to post-intervention (Fisher's exact test p = .024), and 90 % of participants reported decreased anxiety scores post-intervention. Coping skills related negatively to anxiety (r = -.65, p = .04) and depression (r = -.88, p = .001). Post-intervention, the group independently formed their own Facebook group and requested to continue meeting monthly. Although generalizability is limited due to the small sample size, this successful pilot study paves the way for larger studies to examine the efficacy of MBSR interventions in adolescents with high-risk cardiac diagnoses.
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Affiliation(s)
- Vicki A Freedenberg
- Division of Cardiology, Children's National Health System, 111 Michigan Ave., N.W., Washington, DC, 20010, USA,
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Gilden R, McElroy K, Friedmann E, Witherspoon NO, Paul H. Evaluation of the Children's Environmental Health Network's environmental stewardship checklist responses. J Environ Health 2015; 77:22-28. [PMID: 25796699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Children are subject to multiple hazards on a daily basis, including in child care facilities. Research has shown that children in the child care setting may be exposed to lead, radon, pesticides, and multiple chemicals that are associated with known or suspected adverse health effects. The authors' study used an existing environmental health endorsement program to describe current practices of child care facilities as related to environmental health and safety. The facilities varied greatly in size and were located mainly in the U.S. with a few from Canada and Australia. A few checklist items had nearly a 100% positive response rate; however, some of the items had more than 10% of the facilities answer "false" or "don't know." Although many areas exist in which these sampled child care facilities are being environmentally responsible, further education is needed, particularly as related to the use of wall-to-wall carpeting, radon testing, aerosols, and air fresheners.
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Chapa DW, Akintade B, Thomas SA, Friedmann E. Gender differences in stroke, mortality, and hospitalization among patients with atrial fibrillation: A systematic review. Heart Lung 2015; 44:189-98. [PMID: 25703992 DOI: 10.1016/j.hrtlng.2015.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 01/15/2015] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To conduct a systematic review of gender differences in stroke, mortality, and hospitalization for patients with atrial fibrillation and/or flutter (AF/Afl). METHODS Full texts, published, peer-reviewed, English language articles from 1999 through July 2014 were examined. Articles with populations of patients with AF/Afl were included if they conducted longitudinal analysis of any of three outcomes: stroke, mortality, and hospitalization, and reported or compared at least one of the outcomes according to gender. RESULTS Seventeen articles were included: sixteen on stroke, nine on mortality, and one on hospitalization. In nine articles women had more strokes (RRs 0.89-1.9). Findings about gender differences in mortality (RRs 0.69-2.8) and hospitalizations were equivocal. CONCLUSIONS Few articles examine differences in outcomes between men and women with AF/Afl. Given the prevalence of AF/Afl and health care costs it is vital to determine gender differences to evaluate appropriate therapies to decrease stroke, mortality, and hospitalizations.
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Affiliation(s)
- Deborah W Chapa
- George Washington University, School of Nursing, 2030 M Street NW, Suite 300, Washington, DC 20036, USA.
| | - Bimbola Akintade
- University of Maryland, Baltimore, School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, USA
| | - Sue A Thomas
- University of Maryland, Baltimore, School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, USA
| | - Erika Friedmann
- University of Maryland, Baltimore, School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, USA
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Nahm ES, Warren J, Friedmann E, Brown J, Rouse D, Kyung Park B, Quigley KW. Implementation of a Participant-Centered Weight Management Program for Older Nurses: A Feasibility Study. Online J Issues Nurs 2014; 19:4. [PMID: 26824152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
American nurses (3.06 million) are at high risk for being overweight, as the majority are post-menopausal women (93.3% female; mean age 47). Studies have indicated that more than half of all nurses are either overweight or obese. This fact is of concern because nurses often lead major health promotion efforts. The aim of this study was to examine the feasibility of a novel participant-centered weight management program (PCWM) among nurses. The participant-centered (P-C) theoretical framework used originated from the field of usability engineering (i.e., user-centered design). Study methods included a single group pre-test/post-test design (baseline, eight weeks, three months) and an intervention consisting of face-to-face education sessions, technology-augmented exercise programs, and an eHealth portal. The results demonstrated a significant decrease in body weight, increased fruit and vegetable consumption, and increased exercise at eight weeks. In our discussion of this study, we note that although the intervention effects decreased at three months, these results are promising, considering that the intervention used was not regimented and relied only on nurses' activation of their planned health behaviors. The major limitation of the study was the small sample size recruited from one large community hospital. Further research is needed to improve the sustainability of the program.
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Turkeltaub PC, Yearwood EL, Friedmann E. Effect of a brief seated massage on nursing student attitudes toward touch for comfort care. J Altern Complement Med 2014; 20:792-9. [PMID: 25140587 DOI: 10.1089/acm.2014.0142] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While massage has been removed from nursing curricula, studies have reported massage as safe and effective for stress reduction, relaxation, pain relief, fatigue, and quality of life. OBJECTIVE To compare the efficacy of two intensities of touch administered during two seated massages on the attitudes of nursing students toward touch for their self-care and patient care. PARTICIPANTS Nursing students who volunteered gave institutional review board-approved written informed consent to undergo massage by a licensed massage therapist. SETTINGS/LOCATION A private room adjacent to the nursing lab in a school of nursing. INTERVENTION Brief seated massages of differing intensities. Each participant received low-intensity and high-intensity touch in a two-block, randomized order, within-subjects design. Linear mixed models nested within subject and random intercept analyses were used to test hypotheses in this two-treatment, two-sequence, two-period crossover design. OUTCOME MEASURES Health questionnaires/visual analogue scales pertaining to physical/affective/and attitudinal status were completed before and after each massage. RESULTS Twenty-nine participants (93% female, 83% single) completed the study. Before massage, the optimal intensity of touch anticipated for self-comfort was 6.6 (0=no pressure;10=most intense pressure imaginable). The mean touch intensities were 6.7 for high-intensity massage and 0.5 for low-intensity (p<0.001). The overall percentage differences (feeling better or worse) following massage were as follows: low intensity, 37.5% better; high intensity, 62.7% better (p<0.001). Significantly more improvement was reported for energy, pain, stress, and feeling physically uptight after high-intensity compared with low-intensity (p<0.03). Participants were more likely to both receive touch for self-care and provide touch for patient care after experiencing high- versus low-intensity massage (p<0.01). CONCLUSIONS High-intensity seated massage was more efficacious than low-intensity massage and positively influenced nursing student attitudes toward the inclusion of massage in self-care/patient care. The role of touch for self-care/patient care in the nursing curricula merits reconsideration.
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Affiliation(s)
- Paul C Turkeltaub
- 1 Department of Nursing, School of Nursing and Health Studies, Georgetown University , Washington, DC
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Chapa DW, Akintade B, Son H, Woltz P, Hunt D, Friedmann E, Hartung MK, Thomas SA. Pathophysiological Relationships Between Heart Failure and Depression and Anxiety. Crit Care Nurse 2014; 34:14-24; quiz 25. [DOI: 10.4037/ccn2014938] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Depression and anxiety are common comorbid conditions in patients with heart failure. Patients with heart failure and depression have increased mortality. The association of anxiety with increased mortality in patients with heart failure is not established. The purpose of this article is to illustrate the similarities of the underlying pathophysiology of heart failure, depression, and anxiety by using the Biopsychosocial Holistic Model of Cardiovascular Health. Depression and anxiety affect biological processes of cardiovascular function in patients with heart failure by altering neurohormonal function via activation of the hypothalamic-pituitary-adrenal axis, autonomic dysregulation, and activation of cytokine cascades and platelets. Patients with heart failure and depression or anxiety may exhibit a continued cycle of heart failure progression, increased depression, and increased anxiety. Understanding the underlying pathophysiological relationships in patients with heart failure who experience comorbid depression and/or anxiety is critical in order to implement appropriate treatments, educate patients and caregivers, and educate other health professionals.
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Affiliation(s)
- Deborah W. Chapa
- Deborah Chapa is an assistant professor and coordinator of bachelor of nursing science to doctor of nursing practice at George Washington University, School of Nursing, Washington, DC. She is also an acute care nurse practitioner
| | - Bimbola Akintade
- Bimbola Akintade is an assistant professor in the trauma, critical care, emergency department and clinical nurse specialist nurse practitioner program at the University of Maryland, School of Nursing, and an acute care nurse practitioner at Washington Hospital Center, Baltimore, Maryland
| | - Heesook Son
- Heesook Son is an assistant professor at Chung-Ang University School of Nursing, Seoul, South Korea
| | - Patricia Woltz
- Patricia Woltz is director of nursing research at the University of Maryland Medical Center in Baltimore
| | - Dennis Hunt
- Dennis Hunt is an assistant professor, physical therapy and human performance, and director of the exercise science program at Florida Gulf Coast University, Fort Meyers, Florida
| | - Erika Friedmann
- Erika Friedmann is a professor at the University of Maryland, School of Nursing
| | - Mary Kay Hartung
- Mary Kay Hartung was a health sciences librarian at Florida Gulf Coast University. She is now retired
| | - Sue Ann Thomas
- Sue Ann Thomas is a professor emeritus of nursing at the University of Maryland School of Nursing
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Ross A, Bevans M, Friedmann E, Williams L, Thomas S. "I am a nice person when I do yoga!!!" A qualitative analysis of how yoga affects relationships. J Holist Nurs 2013; 32:67-77. [PMID: 24166108 DOI: 10.1177/0898010113508466] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE To develop a better understanding of how yoga practice affects one's interpersonal relationships. DESIGN Qualitative. METHOD Content analysis was used to qualitatively analyze written comments (n = 171) made regarding yoga improving interpersonal relationships in a large cross-sectional survey of yoga practitioners (N = 1,067). FINDINGS Four themes were identified: Yoga practice leads to personal transformation, increases social interaction, provides coping mechanisms to weather relationship losses and difficulties, and leads to spiritual transcendence. Practitioners believed that their interpersonal relationships improved because their attitude and perspective had changed, making them more patient, kind, mindful, and self-aware. They expressed an aspect of community that was both practical (they met new friends) and spiritual (they felt they belonged). They thought they could better weather difficulties such as divorce and death. A number discussed feeling a sense of purpose and that their practice contributed to a greater good. CONCLUSIONS There appears to be an aspect of community associated with yoga practice that may be beneficial to one's social and spiritual health. Yoga could be beneficial for populations at risk for social isolation, such as those who are elderly, bereaved, and depressed, as well as individuals undergoing interpersonal crises.
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Kao CW, Chen TY, Cheng SM, Lin WS, Friedmann E, Thomas SA. Gender differences in the predictors of depression among patients with heart failure. Eur J Cardiovasc Nurs 2013; 13:320-8. [DOI: 10.1177/1474515113496493] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 06/13/2013] [Indexed: 11/16/2022]
Affiliation(s)
- Chi-Wen Kao
- National Defense Medical Center, School of Nursing, Taiwan
| | - Ting-Yu Chen
- Chung-Jen College of Nursing, Health Sciences and Management, Taiwan
| | - Shu-Meng Cheng
- National Defense Medical Center, School of Medicine and Department of Internal Medicine, Tri-Service General Hospital, Taiwan
| | - Wei-Shiang Lin
- National Defense Medical Center, School of Medicine and Department of Internal Medicine, Tri-Service General Hospital, Taiwan
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Levine GN, Allen K, Braun LT, Christian HE, Friedmann E, Taubert KA, Thomas SA, Wells DL, Lange RA. Pet ownership and cardiovascular risk: a scientific statement from the American Heart Association. Circulation 2013; 127:2353-63. [PMID: 23661721 DOI: 10.1161/cir.0b013e31829201e1] [Citation(s) in RCA: 184] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ross A, Friedmann E, Bevans M, Thomas S. National survey of yoga practitioners: mental and physical health benefits. Complement Ther Med 2013; 21:313-23. [PMID: 23876562 DOI: 10.1016/j.ctim.2013.04.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 04/01/2013] [Accepted: 04/02/2013] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To describe yoga practice and health characteristics of individuals who practice yoga, and to explore their beliefs regarding the effects of their yoga practice on their health. DESIGN A cross-sectional design with anonymous online surveys. SETTING 4307 randomly selected individuals from 15 US Iyengar yoga studios (n=18,160), representing 41 states; 1087 individuals responded, with 1045 (24.3%) surveys completed. OUTCOME MEASURES Freiberg Mindfulness Inventory, Mental Health Continuum (subjective well-being), Multi-factor Screener (diet), PROMIS sleep disturbance, fatigue, and social support, International Physical Activity Questionnaire. RESULTS Age: 19-87 years (M=51.7 ± 11.7), 84.2% female, 89.2% white, 87.4% well educated (≥ bachelor's degree). Mean years of yoga practice=11.4 (± 7.5). BMI=12.1-49.4 (M=23.1 ± 3.9). Levels of obesity (4.9%), smoking (2%), and fruit and vegetable consumption (M=6.1 ± 1.1) were favorable compared to national norms. 60% reported at least one chronic/serious health condition, yet most reported very good (46.3%) or excellent (38.8%) general health. Despite high levels of depression (24.8%), nearly all were moderately mentally healthy (55.2%) or flourishing (43.8%). Participants agreed yoga improved: energy (84.5%), happiness (86.5%), social relationships (67%), sleep (68.5%), and weight (57.3%), and beliefs did not differ substantially according to race or gender. The more they practiced yoga, whether in years or in amount of class or home practice, the higher their odds of believing yoga improved their health. CONCLUSIONS Individuals who practice yoga are not free of health concerns, but most believe their health improved because of yoga. Yoga might be beneficial for a number of populations including elderly women and those with chronic health conditions.
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Affiliation(s)
- Alyson Ross
- University of Maryland School of Nursing, Baltimore, MD, United States.
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Abstract
Spouses are the key in the recovery and coping of patients after a myocardial infarction (MI). The purpose of this study was to examine changes in coping for spouses of post-MI patients over time. The study determined the contributions of a spouse’s demographic factors and of time since the MI to the changes in coping. A secondary data analysis from the Patients’ and Families’ Psychological Response to Home Automated External Defibrillator Trial was conducted. On average, older spouses coped better than younger spouses. Coping significantly decreased over time. The spouse’s coping decreased for spouses whose baseline coping was higher. Coping decreased more rapidly for spouses of patients who experienced an MI more recently. Patients and spouses need support to improve coping after an MI.
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Affiliation(s)
| | - Sue A. Thomas
- University of Maryland School of Nursing, Baltimore, USA
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Woltz PC, Chapa DW, Friedmann E, Son H, Akintade B, Thomas SA. Effects of interventions on depression in heart failure: A systematic review. Heart Lung 2012; 41:469-83. [DOI: 10.1016/j.hrtlng.2012.06.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 05/23/2012] [Accepted: 06/03/2012] [Indexed: 11/24/2022]
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Son H, Thomas SA, Friedmann E. The association between psychological distress and coping patterns in post-MI patients and their partners. J Clin Nurs 2012; 21:2392-4. [DOI: 10.1111/j.1365-2702.2012.04165.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Affiliation(s)
- Robyn Gilden
- Family and Community Health; University of Maryland School of Nursing; Baltimore; Maryland
| | - Erika Friedmann
- Organizational Systems and Adult Health; University of Maryland School of Nursing; Baltimore; Maryland
| | | | | | - Kathleen McPhaul
- Family and Community Health; University of Maryland School of Nursing; Baltimore; Maryland
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Abstract
Evidence supports the contribution of depression, anxiety, and poor social support to mortality of hospitalized myocardial infarction (MI) patients. The contribution of depression to survival is independent of disease severity. Pet ownership, a non-human form of social support, has also been associated with one year survival of post-MI patients. The current study addresses whether pet ownership contributes independently to long term survival beyond the contributions of depression, anxiety, or low social support in post-MI patients who have already survived at least 6 months. Data from patients (N = 460) enrolled in the "Psychosocial Responses in the Home Automated External Defibrillator Trial (PR-HAT)"were used. Seventeen patients died during a median follow-up of 2.8 years. In Cox proportional hazards regression model that included depression, lack of pet ownership, and the interaction between depression and lack of pet ownership, not owning a pet was the only significant independent predictor of mortality (p = 0.036). The interaction between pet ownership and depression tended to be significant indicating that the effect of pet ownership on survival in this group of people who have supportive spouses/companions living with them may relate to depression.
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Affiliation(s)
- Erika Friedmann
- University of Maryland School of Nursing, 655 W. Lombard Street, Baltimore, MD 21201 USA
| | - Sue A. Thomas
- University of Maryland School of Nursing, 655 W. Lombard Street, Baltimore, MD 21201 USA
| | - Heesook Son
- University of Maryland School of Nursing, 655 W. Lombard Street, Baltimore, MD 21201 USA
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Thomas SA, Friedmann E, Lee HJ, Son H, Morton PG. Changes in anxiety and depression over 2 years in medically stable patients after myocardial infarction and their spouses in the Home Automatic External Defibrillator Trial (HAT): a longitudinal observational study. Heart 2010; 97:371-81. [PMID: 20930046 DOI: 10.1136/hrt.2009.184119] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To compare the long-term effects of cardiopulmonary resuscitation (CPR) training and CPR/automatic external defibrillator (AED) training on anxiety and depression of patients who were medically stable after myocardial infarction (MI) and of their spouses/companions. DESIGN Longitudinal. PARTICIPANTS Post-MI patients (N=460) and their spouses/companions from the Home Automatic External Defibrillator Trial. MAIN OUTCOME MEASURES Depression (Beck Depression Inventory-II scores) and anxiety (State Trait Anxiety Inventory scores). RESULTS At study entry, 25% of the patients and 15% of their spouses were depressed and 21% of the patients and 19% of the spouses were anxious. The prevalence of depression and anxiety did not change over time in the patients or their spouses. Average depression and anxiety decreased for patients but not for spouses. An intervention group did not contribute significantly to these changes. Psychological distress, indicated by depression or anxiety of the spouse or the patient, occurred in 191 couples. Among psychologically distressed patients (N=128), depression and anxiety decreased over time; the intervention group did not contribute to these changes. The reduction in anxiety among male patients was greater than in female patients (p=0.012, 95% CI 0.002 to 0.018). Among psychologically distressed spouses (N=118), depression decreased over time independently of the intervention. Changes in spouse anxiety depended on the intervention group (p=0.012, 95% CI 0.001 to 0.012); anxiety decreased significantly in the CPR and remained high in the CPR/AED group. CONCLUSION There was no evidence that home AEDs caused psychological distress among patients. Even among those who were psychologically distressed when they were assigned to receive either CPR training or CPR/AEDs, home AEDs did not influence changes in patients' depression or anxiety or spouses' depression in comparison with CPR training. Among psychologically distressed spouses, AEDs may keep anxiety higher than it would be otherwise. Interventions to reduce anxiety of spouses who are psychologically distressed may be indicated when their partners receive an AED.
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Affiliation(s)
- Sue A Thomas
- University of Maryland School of Nursing, 655 W. Lombard St., Baltimore, MD 21201 USA.
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Von Rueden KT, Hinderer KA, McQuillan KA, Murray M, Logan T, Kramer B, Gilmore R, Friedmann E. Secondary Traumatic Stress in Trauma Nurses. J Trauma Nurs 2010; 17:191-200. [DOI: 10.1097/jtn.0b013e3181ff2607] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chapa D, Thomas S, Friedmann E. Results of PFOS trial. Heart Lung 2010. [DOI: 10.1016/j.hrtlng.2010.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
The human-animal bond is extremely important to most clients of small animal veterinary practices. Pet ownership, or just being in the presence of a companion animal, is associated with health benefits, including improvements in mental, social, and physiologic health status. This article provides the research data regarding the human health benefits of companion animals, animal-assisted therapy, animal-assisted activities, and assistance animals; reviews measures that can be taken to enable safe pet ownership for the immunocompromised, and discusses the veterinarian's role in supporting immune-compromised clients and clients who have assistance animals. Client education and enhanced veterinary care can reduce the risk from zoonotic diseases, even for the immunocompromised.
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Affiliation(s)
- Erika Friedmann
- University of Maryland School of Nursing, 655 W. Lombard Street, Baltimore, MD 21201, USA.
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