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Kum C, Jones HJ, Miller EL, Kreitzer N, Bakas T. Theoretically Based Factors Associated With Stroke Family Caregiver Health. Rehabil Nurs 2024; 49:86-94. [PMID: 38696434 PMCID: PMC11068090 DOI: 10.1097/rnj.0000000000000458] [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] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
PURPOSE Most persons who have had strokes are cared for at home by family members-many of whom experience depressive symptoms and quality of life changes as a result of providing care. The objective of this study is to determine theoretically based factors associated with unhealthy days in stroke family caregivers. RESEARCH DESIGN AND METHODS Secondary data analysis was conducted using baseline data from a large randomized controlled clinical trial testing the Telephone Assessment and Skill-Building Kit program with 254 family caregivers of persons who have had strokes. Guided by a conceptual model derived from Lazarus' transactional approach to stress, data were analyzed using multiple regression with unhealthy days as the dependent variable and theoretically based factors as independent variables. RESULTS Caregivers were mostly female (78%), White (71%), spouses (47%), or adult children (29%). Caregivers reported nine unhealthy days on average within the past month. A total of 37.8% of the variance in unhealthy days was explained by caregiver task difficulty, level of optimism, threat appraisal, depressive symptoms, and life changes with depressive symptoms being the strongest individual predictor because of shared variance. CLINICAL RELEVANCE Unhealthy days is an important part of stroke family caregiver health. Factors associated with unhealthy days in this study provide areas to consider in future intervention development.
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Affiliation(s)
- Cleopatra Kum
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Holly J Jones
- The Ohio State University College of Nursing, Columbus, OH, USA
| | - Elaine L Miller
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Natalie Kreitzer
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
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2
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Shehab M, Cohen RM, Brehm B, Bakas T. Accuracy and Feasibility of Using a Smartphone Application for Carbohydrate Counting Versus Traditional Carbohydrate Counting for Adults With Insulin-Treated Diabetes. J Diabetes Sci Technol 2024:19322968241248606. [PMID: 38682598 DOI: 10.1177/19322968241248606] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
BACKGROUND Patients with insulin-treated diabetes struggle with performing accurate carbohydrate counting for proper blood glucose control. Little is known about the comparative accuracy and feasibility of carbohydrate counting methods. PURPOSE The purpose of this study was to determine whether carbohydrate counting using a smartphone application is more accurate and feasible than a traditional method. THEORETICAL/CONCEPTUAL FRAMEWORK Based on a conceptual model derived from the Technology Acceptance Model, feasibility was defined as usefulness, ease of use, and behavioral intention to use each method. METHODS A standardized meal was presented to 20 adults with insulin-treated diabetes who counted carbohydrates using traditional and smartphone methods. Accuracy was measured by comparing carbohydrate counting estimates with the standardized meal values. Perceived feasibility (usefulness, ease of use, behavioral intention) was measured using rating forms derived from the Technology Acceptance Model. RESULTS The number of training and estimation minutes were significantly higher for the traditional method than the smartphone method (Z = -3.83, P < .05; Z = -2.30, P < .05). The traditional method took an additional 1.4 minutes for estimation and 12.5 minutes for training. There were no significant differences in accuracy between traditional and smartphone methods for carbohydrate counting (Wilcoxon signed-rank test, Z = -1.10, P = .28). There were no significant differences between traditional and smartphone methods for feasibility (usefulness, Z = -.10, P = .95; ease of use, Z = -.36, P = .72; or behavioral intention, Z = -.94, P = .35). CONCLUSION While both traditional and smartphone methods were found to be similar in terms of accuracy and feasibility, the smartphone method took less time for training and for carbohydrate estimation.
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Affiliation(s)
- Mohammad Shehab
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Robert M Cohen
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Bonnie Brehm
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
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3
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Weber A, Bakas T, Schulman-Green D, Voos KC, Rice JB, Bailey R, Reigel A, Oudat Q, Holmes M, Tubbs-Cooley HL, Kaplan HC. Family Management Skills Reported by Parents of Preterm Infants in the NICU Using the Self- and Family Management Framework (SFMF). Adv Neonatal Care 2024; 24:119-131. [PMID: 38127650 PMCID: PMC10978294 DOI: 10.1097/anc.0000000000001140] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
BACKGROUND Across the globe, family-integrated care (FICare) has become an evidence-based standard in which parents deliver the majority of infant care in the neonatal intensive care unit (NICU). Because of extensive barriers to parent presence, adaptations to FICare may be required for successful implementation. Family management theory may provide structure to the Parent Education of FICare and help nurses guide parents' skill development as equal care members. PURPOSE To identify family management skills employed by NICU parents using the Self- and Family Management Framework (SFMF). METHODS We conducted secondary analyses of qualitative interview data from NICU parents (n = 17) who shared their experiences of using family management skills to care for their infant. We categorized skills according to 3 main self- and family management processes: Focusing on Infant Illness Needs; Activating Resources; and Living With Infant Illness. RESULTS Parents reported several family management skills currently identified in the SFMF, as well as new skills such as conflict management, power brokerage, and addressing resources related to social determinants of health. Parent activation of resources was critical to sustaining parent focus on the infant's illness needs. IMPLICATIONS FOR PRACTICE AND RESEARCH By teaching skills that parents reported as helping them manage infant care, neonatal nurses may better facilitate parent integration into the care team. Future researchers can incorporate the skills identified in this study into the design of family management interventions that facilitate FICare implementation in the United States.
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Affiliation(s)
- Ashley Weber
- Author Affiliations: University of Cincinnati College of Nursing, Cincinnati, Ohio (Drs Weber and Bakas and Mr Oudat); New York University Rory Meyers College of Nursing, New York City, New York (Dr Schulman-Green); Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Voos, Mr Bailey, and Mss Reigel and Holmes); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Dr Rice); The Ohio State University, Columbus, Ohio (Dr Tubbs-Cooley); and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Kaplan)
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Williams-Farrelly MM, Schroeder MW, Li C, Perkins AJ, Bakas T, Head KJ, Boustani M, Fowler NR. Loneliness in older primary care patients and its relationship to physical and mental health-related quality of life. J Am Geriatr Soc 2024; 72:811-821. [PMID: 38240340 PMCID: PMC10947914 DOI: 10.1111/jgs.18762] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/09/2023] [Accepted: 12/03/2023] [Indexed: 03/19/2024]
Abstract
BACKGROUND Loneliness is a significant public health challenge in the United States, especially among older adults. The epidemiology of loneliness among older adults in primary care is lacking, and specific research is needed on how loneliness impacts older primary patients' physical, mental, and cognitive health. A large sample of older primary care patients were recruited for a trial during the COVID-19 pandemic to measure the relationship between loneliness and physical and mental quality of life (QOL). METHODS Baseline data come from the Caregiver Outcomes of Alzheimer's Disease Screening (COADS) study, an ongoing randomized controlled trial evaluating benefits and risks of Alzheimer's disease and related dementias screening among primary care patients ages 65 and older, collected April 2020 to September 2021. Loneliness was measured with the 5-item, Loneliness Fixed Form Ages 18+ from The NIH Toolbox Emotion Battery, physical and mental health-related QOL was measured with the SF-36v2, and depression and anxiety severity were measured with the PHQ-9 and GAD-7, respectively. RESULTS Spearman correlation analyses revealed that loneliness was moderately correlated with mental health QOL (r[601] = -0.43, p < 0.001), anxiety severity (r[601] = 0.44, p < 0.001), and depression severity (r[601] = 0.42, p < 0.001), while weakly correlated with physical health QOL (r[601] = -0.15, p < 0.001). After conducting unadjusted and adjusted linear regression models, we found that loneliness was significantly associated with both lower mental (p < 0.001) and physical (p < 0.001) QOL. Furthermore, loneliness remained significantly associated with worse mental QOL after adjusting for age, gender, race, ethnicity, educational level, perceived income status, neighborhood disadvantage, severity of comorbidities, and comorbid depression and anxiety. CONCLUSION Primary care providers should discuss loneliness with their older adult patients and provide resources to help patients develop and maintain meaningful social relationships.
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Affiliation(s)
- Monica M. Williams-Farrelly
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Indianapolis, IN, 46202, USA
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Indiana University Center for Aging Research, Indianapolis, IN, 46202, USA
- Regenstrief Institute, Inc., Indianapolis, IN, 46202, USA
| | - Matthew W. Schroeder
- Indiana University Center for Aging Research, Indianapolis, IN, 46202, USA
- Regenstrief Institute, Inc., Indianapolis, IN, 46202, USA
| | - Claudia Li
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Anthony J. Perkins
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Biostatistics and Health Data Science, Indianapolis, IN, 46202, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH, 45219, USA
| | - Katharine J. Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, 46202, USA
| | - Malaz Boustani
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Indianapolis, IN, 46202, USA
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Indiana University Center for Aging Research, Indianapolis, IN, 46202, USA
- Regenstrief Institute, Inc., Indianapolis, IN, 46202, USA
| | - Nicole R. Fowler
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Indianapolis, IN, 46202, USA
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Indiana University Center for Aging Research, Indianapolis, IN, 46202, USA
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Jones HJ, Kovacic MB, Bacchus P, Almallah W, Bakas T. Participant Satisfaction in a Cardiovascular Disease Prevention Intervention for Midlife Black Women. West J Nurs Res 2024; 46:3-9. [PMID: 37905540 DOI: 10.1177/01939459231208420] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
BACKGROUND Midlife Black women suffer disproportionately from cardiovascular disease and are 65% more likely to die following a cardiac event compared with White women. Recruitment and retention of midlife Black women in clinical trials has been historically low. The culturally tailored Midlife Black Women's Stress Reduction and Wellness (B-SWELL) intervention was codeveloped with the community and designed to lower cardiovascular disease risk in midlife Black women. OBJECTIVES We sought to assess participant satisfaction in the randomized feasibility trial of the B-SWELL intervention. METHODS A feasibility trial comparing the B-SWELL to a wellness intervention was conducted in the winter and spring of 2021 in compliance with pandemic research protocols. An adapted survey tool was used to rate satisfaction with the intervention and its technology using a Likert-type scale (1 [strongly disagree] to 5 [strongly agree]). Survey subscales assessed usefulness, ease, and acceptability of the intervention(s). RESULTS Randomization yielded no statistical demographic differences (N = 48). Satisfaction for the interventions was high in both the B-SWELL and Wellness intervention groups with mean scores of 4.57 and 4.56, respectively. Mean scores for technology were 4.49 for the B-SWELL and 4.47 for the Wellness group. Subscales were also rated highly. Narrative responses were positively aligned with satisfaction scores. CONCLUSIONS Results support use of cultural adaptation and community participatory methods to develop and deliver interventions targeted to at-risk populations. Culturally adapted interventions designed in collaboration with the community have greater authenticity, increasing the potential for higher recruitment, retention, and participant satisfaction of underrepresented populations. The trial is registered in ClinicalTrials.gov (NCT04404478).
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Affiliation(s)
- Holly J Jones
- The Martha S. Pitzer Center for Women, Children, and Youth, College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Melinda Butsch Kovacic
- College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
- College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Patricia Bacchus
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Wala'a Almallah
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
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6
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Abu-Alhaija D, Miller E, Shaughnessy E, Bakas T. Psychometric Testing of the Oncology Nurses Health Behaviors Determinants Scale: A Cross-Sectional Study. Semin Oncol Nurs 2023; 39:151515. [PMID: 37880012 PMCID: PMC10841541 DOI: 10.1016/j.soncn.2023.151515] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES Adherence by oncology nurses to chemotherapy safe handling guidelines is essential to prevent hazards of chemotherapy exposure. A review of the literature revealed the need for an instrument with evidence of reliability and validity to measure factors influencing adherence to safe chemotherapy-handling guidelines among oncology nurses. The purpose of this study was to psychometrically test the Oncology Nurses' Health Behaviors Determinants Scale (HBDS-ON) that measures the mentioned factors. DATA SOURCES Methodological research of a quantitative cross-sectional survey design was used. The study surveys were administered by email to a sample of 108 oncology nurses. Cronbach alpha, item analysis, exploratory factor analysis using principal axis factoring, and convergence validity testing were used to test reliability and validity. CONCLUSION Factor analysis yielded six subscales, each having acceptable internal consistency reliability (Cronbach alpha between 0.70 and 0.88). The subscales included four oncology nurse health beliefs (perceived threat, benefits, barriers, and self-efficacy), cues to action, and personal protective equipment availability and accessibility. Convergence validity testing results support the Oncology Nurses Health Behaviors Determinant Scale (HBDS-ON) construct validity. Oncology nurses' self-efficacy to adherence to chemotherapy-handling guidelines, the perceived barriers to adhere to chemotherapy-handling guidelines, and cues to action are associated with adherence to chemotherapy-handling guidelines. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses' health beliefs, the cues to action, and personal protection equipment availability and accessibility are important determinants of nurses' adherence to chemotherapy-handling guidelines. The HBDS-ON is an instrument that has evidence of reliability and validity and could be used in practice to measure these determinants.
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Affiliation(s)
- Dania Abu-Alhaija
- Assistant Professor, University of Cincinnati College of Nursing, Cincinnati, OH.
| | - Elaine Miller
- Professor, University of Cincinnati College of Nursing, Cincinnati, OH
| | - Elizabeth Shaughnessy
- Professor of Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati OH
| | - Tamilyn Bakas
- Professor and Jane E. Proctor Endowed Chair, University of Cincinnati College of Nursing, Cincinnati, OH
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7
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Stacy KE, Lambert J, Shatz R, Bakas T. Development and Validation of the Lewy Body Disease Caregiver Activities Scale. J Nurs Meas 2023; 31:606-614. [PMID: 37353322 DOI: 10.1891/jnm-2021-0100] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
Background and Purpose: Caring for someone with Lewy body disease (LBD) is difficult. This study describes the development and validity testing of the LBD Caregiver Activities Scale (LBD-CAS). Methods: Caregiver interviews informed the development of the LBD-CAS. Experts estimated the content validity of items (I-CVI) and provided feedback about the scale. Family caregivers evaluated items for face validity. Results: Expert I-CVI ratings yielded 49 items with scores of 0.83 or higher. Four items with I-CVI scores <.83 were retained due to conceptual significance. The overall scale CVI was 0.86. Items evaluated by caregivers for face validity showed excellent variability in responses, with no major ceiling or floor effects. Conclusions: LBD-CAS showed evidence of content and face validity for the assessment of activities performed by LBD caregivers. Further psychometric testing is recommended.
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Affiliation(s)
- Kelly E Stacy
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Joshua Lambert
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Rhonna Shatz
- University of Cincinnati Department of Neurology and Rehabilitation, Cincinnati, OH, USA
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
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8
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Fowler NR, Perkins AJ, Park S, Schroeder MW, Boustani MA, Head KJ, Bakas T. Relationship between health-related quality of life, depression, and anxiety in older primary care patients and their family members. Aging Ment Health 2023:1-7. [PMID: 38019031 DOI: 10.1080/13607863.2023.2285499] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVES Patient-family member dyads experience transitions through illness as an interdependent team. This study measures the association of depression, anxiety, and health-related quality of life (HRQOL) of older adult primary care patient-family member dyads. METHODS Baseline data from 1,808 patient-family member dyads enrolled in a trial testing early detection of Alzheimer's disease and related dementias in primary care. Actor-Partner Independence Model was used to analyze dyadic relationships between patients' and family members' depression (PHQ-9), anxiety (GAD-7), and HRQOL (SF-36 Physical Component Summary score and Mental Component Summary score). RESULTS Family member mean (SD) age is 64.2 (13) years; 32.2% male; 84.6% White; and 64.8% being the patient's spouse/partner. Patient mean (SD) age is 73.7 (5.7) years; 47% male; and 85.1% White. For HRQOL, there were significant actor effects for patient and family member depression alone and depression and anxiety together on their own HRQOL (p < 0.001). There were significant partner effects where family member depression combined with anxiety was associated with the patient's physical component summary score of the SF-36 (p = 0.010), and where the family member's anxiety alone was associated with the patient's mental component summary score of the SF-36 (p = 0.031). CONCLUSION Results from this study reveal that many dyads experience covarying health status (e.g. depression, anxiety) even prior to entering a caregiving situation.
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Affiliation(s)
- Nicole R Fowler
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana University Center for Aging Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc, Indianapolis, IN, USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis, IN, USA
| | - Anthony J Perkins
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine & Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Seho Park
- Regenstrief Institute, Inc, Indianapolis, IN, USA
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine & Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Matthew W Schroeder
- Indiana University Center for Aging Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc, Indianapolis, IN, USA
| | - Malaz A Boustani
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana University Center for Aging Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc, Indianapolis, IN, USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis, IN, USA
| | - Katharine J Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
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Kreitzer N, Adeoye O, Wade SL, Kurowki BG, Thomas S, Gillespie L, Bakas T. Iterative Development of the Caregiver Wellness After Traumatic Brain Injury Program (CG-Well). J Head Trauma Rehabil 2023; 38:E424-E436. [PMID: 36951450 PMCID: PMC10517076 DOI: 10.1097/htr.0000000000000869] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
OBJECTIVES (1) To iteratively design a web/phone-based intervention to support caregivers of adults acutely following traumatic brain injury (TBI), Caregiver Wellness (CG-Well), and (2) to obtain qualitative and quantitative feedback on CG-Well from experts and caregivers to refine the intervention. SETTING A level I trauma and tertiary medical center. PARTICIPANTS Convenience sample of a total of 19 caregivers and 25 experts. DESIGN Multistep prospective study with iterative changes to CG-Well: (1) developed intervention content based on qualitative feedback from a prior study and literature review; (2) obtained qualitative feedback from 10 experts; (3) refined content using a modified Delphi approach involving 4 caregivers and 6 experts followed by qualitative interviews with 9 caregivers; (4) designed CG-Well website and videos; and (5) obtained feedback on program acceptability, appropriateness, and feasibility from 6 caregivers and 9 experts. INTERVENTIONS CG-Well included content on TBI, self-care and support, and skill-building strategies delivered through a website and telephone calls. MAIN OUTCOME MEASURES Qualitative data were analyzed using content analysis. Caregivers and experts completed Likert-type scales to rate module relevance, clarity, accuracy, utility and website acceptability, appropriateness, and feasibility (1 = strongly disagree to 5 = strongly agree). Means and standard deviations (SD) characterized ratings. RESULTS Qualitative findings were instrumental in designing and refining CG-Well. Ratings were positive for modules (means and SD for relevant [4.9, 0.33], clear [4.6, 0.53], accurate [4.9, 0.33], and useful [5, 0]) and the website (means and SD for acceptable [4.8, 0.36], appropriate [4.8, 0.35], and feasible [4.8, 0.36]). CONCLUSIONS The iterative design process for CG-Well resulted in a highly acceptable program. An early-stage randomized controlled trial is underway to estimate treatment effects for a future well-powered clinical trial.
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Affiliation(s)
- Natalie Kreitzer
- Department of Emergency Medicine (Drs Kreitzer and Gillespie and Ms Thomas) and College of Nursing (Dr Bakas), University of Cincinnati, Cincinnati, Ohio; Department of Emergency Medicine, Washington University, St Louis, Missouri (Dr Adeoye); Departments of Pediatrics (Dr Wade) and Pediatrics and Neurology and Rehabilitation Medicine (Dr Kurowki), Division of Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr Kurowki)
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10
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Oudat Q, Bakas T. Merits and Pitfalls of Social Media as a Platform for Recruitment of Study Participants. J Med Internet Res 2023; 25:e47705. [PMID: 37819692 PMCID: PMC10600643 DOI: 10.2196/47705] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023] Open
Abstract
Efficient and effective methods of recruiting participants for studies have characteristically come with many challenges. The unprecedented rise of social media platforms such as Facebook and Instagram has revolutionized the ease of recruiting participants as compared to more traditional methods such as newspaper or radio advertisements. While these new advancements may seem to increase the success of recruitment, they are not without their own faults and limitations. In this paper, we intend to dissect the advantages and disadvantages of social media platforms in recruiting participants. Specifically, we will discuss the advantages of targeted and rapid recruitment, engagement, and cost reduction as well as the disadvantages of representativeness, privacy concerns, limited control, and limited access.
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Affiliation(s)
- Qutaibah Oudat
- College of Nursing, University of Cincinnati, Cincinnati, OH, United States
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH, United States
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11
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Punches BE, Brown JL, Taul NK, Sall HA, Bakas T, Gillespie GL, Martin-Boone JE, Boyer EW, Lyons MS. Patient motivators to use opioids for acute pain after emergency care. Front Pain Res (Lausanne) 2023; 4:1151704. [PMID: 37818444 PMCID: PMC10560756 DOI: 10.3389/fpain.2023.1151704] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/11/2023] [Indexed: 10/12/2023] Open
Abstract
Introduction Patients are stakeholders in their own pain management. Factors motivating individuals to seek or use opioids therapeutically for treatment of acute pain are not well characterized but could be targeted to reduce incident iatrogenic opioid use disorder (OUD). Emergency departments (EDs) commonly encounter patients in acute pain for whom decisions regarding opioid therapy are required. Decision-making is necessarily challenged in episodic, unscheduled care settings given time pressure, limited information, and lack of pre-existing patient provider relationship. Patients may decline to take prescribed opioids or conversely seek opioids from other providers or non-medical sources. Methods Using a framework analysis approach, we qualitatively analyzed transcripts from 29 patients after discharge from an ED visit for acute pain at a large, urban, academic hospital in the midwestern United States to describe motivating factors influencing patient decisions regarding opioid use for acute pain. A semi-structured interview guide framed participant discussion in either a focus group or interview transcribed and analyzed with conventional content analysis. Results Four major themes emerged from our analysis including a) pain management literacy, b) control preferences, c) risk tolerance, and d) cues to action. Discussion Our findings suggest targets for future intervention development and a framework to guide the engagement of patients as stakeholders in their own acute pain management.
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Affiliation(s)
- Brittany E. Punches
- College of Nursing, The Ohio State University, Columbus, OH, United States
- Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Jennifer L. Brown
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, United States
| | - Natalie K. Taul
- Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Hawa A. Sall
- Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH, United States
| | | | | | - Edward W. Boyer
- Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Michael S. Lyons
- Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
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Abu-Alhaija D, Bakas T, Shaughnessy E, Miller E. The Factors That Influence Chemotherapy Exposure Among Nurses: An Integrative Review. Workplace Health Saf 2023; 71:212-227. [PMID: 36703295 PMCID: PMC10834144 DOI: 10.1177/21650799221140583] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Exposure to chemotherapy is an occupational hazard predisposing nurses to severe health effects. The purpose of this integrative review was to identify the recent literature describing the risk factors for occupational exposure to chemotherapy among nurses. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology was employed to conduct the review. The databases searched were Scopus, PubMed, and CINAHL using the search terms "chemotherapy," "drugs," "exposure," and "nurses." Included articles were published between January 2010 and February 2022, published in peer-reviewed journals for research conducted in the United States, and written in English language. Excluded articles were studies that did not involve nurses in their samples. Review articles, books, theses, and dissertations were excluded as well. The Johns Hopkins Nursing Evidence-Based Practice Model was used to assess the level of evidence from the reviewed studies. FINDINGS Fourteen studies were included in this review. Ten studies were rated on Evidence Level III, two on Evidence Level II, one on Evidence Level I, and one on Evidence Level V. The main risk factors for occupational exposure were nurses' knowledge of chemotherapy handling guidelines, nurses' adherence to using the personal protective equipment, nurses' health beliefs regarding chemotherapy exposure, and workplace-related factors such as workload and managerial support. CONCLUSION Addressing the identified risk factors would protect nurses from chemotherapy exposure. More research on nurses' health beliefs regarding chemotherapy exposure and the cues to adhere to chemotherapy handling guidelines in the work environment is needed.
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Affiliation(s)
| | - Tamilyn Bakas
- Professor of Nursing, Interim Associate Dean for Research, and Jane E. Procter Endowed Chair, University of Cincinnati College of Nursing
| | | | - Elaine Miller
- Professor of Nursing, University of Cincinnati College of Nursing
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13
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Chung SY, Bakas T, Rawl SM, Welch J, Jones J, Ellis R, Hacker ED. The Kidney Transplant Self-Management Scale: Instrument Development and Psychometric Testing. West J Nurs Res 2023; 45:34-45. [PMID: 35148648 DOI: 10.1177/01939459211072368] [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] [Indexed: 11/17/2022]
Abstract
This study reports the development and psychometric testing of the Kidney Transplant Self-Management Scale (KT-SMS). The instrument development phase included the following: (a) conceptual definition, item generation, and framework; (b) face validity assessment; and (c) content validity assessment. The psychometric testing phase included the following: (a) construct validity testing; (b) internal consistency reliability testing; (c) convergent validity testing; and (d) predictive power of the KT-SMS using a cross-sectional sample of kidney transplant recipients (N = 153). Factor analysis results supported the 16-item KT-SMS as multidimensional with five domains (medication adherence, cardiovascular risk reduction, protecting kidney, ownership, and skin cancer prevention). Internal consistency reliability for the total scale and five subscales was adequate. Convergent validity was supported as the intercorrelations of the KT-SMS total score with the five subscales were significant. The KT-SMS total score and five subscales were significantly correlated with self-efficacy for managing chronic disease, patient activation, and health-related quality of life.
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Affiliation(s)
- Shu-Yu Chung
- School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Susan M Rawl
- School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Janet Welch
- School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Josette Jones
- School of Informatics and Computing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Rebecca Ellis
- School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Eileen D Hacker
- School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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14
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Abu-Alhaija D, Miller E, Bakas T, Shaughnessy E. The Development and the Content Validation of the Oncology Nurses Health Behaviors Determinants Scale. Semin Oncol Nurs 2022; 38:151317. [PMID: 35871026 PMCID: PMC10823865 DOI: 10.1016/j.soncn.2022.151317] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/27/2022] [Accepted: 06/26/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Chemotherapy exposure is an occupational hazard affecting oncology nurses. The adherence to chemotherapy-handling guidelines is essential to prevent exposure to these drugs. Oncology nurses' health beliefs and the cues in the environment are factors influencing the adherence to these guidelines. There is a lack of instruments with evidence of reliability and validity in the literature that address these factors. The purpose of this article is to describe the development and the content validation of the Oncology Nurses' Health Behaviors' Determinants Scale relative to adherence to chemotherapy-handling guidelines. DATA SOURCES This study was conducted in two phases: item development, then, content validation using a quantitative cross-sectional design with an exploratory part. A convenience sample of seven experts reviewed the items for relevance, wording, and comprehensiveness. The initial version of the scale that was sent to experts contained 65 items. CONCLUSION The Oncology Nurses' Health Behaviors Determinants' Scale has evidence of content validity. Twenty-eight items in the final instrument met the required level of content validity (item content validity index = 0.83). Four additional items were retained due to conceptual significance. Two items were added. The final scale contains 34 items with a total scale content validity index = 0.90. IMPLICATIONS FOR NURSING PRACTICE This newly developed instrument could be used to assess the factors that influence chemotherapy exposure among oncology nurses in the light of the Health Belief Model. Following that, interventions can be developed and implemented to foster greater adherence to safe chemotherapy handling guidelines.
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Affiliation(s)
- Dania Abu-Alhaija
- Postdoctoral Fellow, University of Cincinnati College of Nursing, Cincinnati, Ohio.
| | - Elaine Miller
- Professor of Nursing, University of Cincinnati College of Nursing, Cincinnati, Ohio
| | - Tamilyn Bakas
- Professor of Nursing and Jane E. Proctor Endowed Chair, University of Cincinnati College of Nursing, Cincinnati, Ohio
| | - Elizabeth Shaughnessy
- Professor of Surgery, College of Medicine/University of Cincinnati Medical Center, Cincinnati, Ohio
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15
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Stacy KE, Miller E, Shatz R, Bakas T. COVID‐19 related life changes for family caregivers of persons with Lewy body disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.068809] [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: 12/24/2022]
Affiliation(s)
- Kelly E Stacy
- University of Cincinnati College of Nursing Cincinnati OH USA
| | - Elaine Miller
- University of Cincinnati College of Nursing Cincinnati OH USA
| | | | - Tamilyn Bakas
- University of Cincinnati College of Nursing Cincinnati OH USA
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16
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Jones HJ, Butsch Kovacic M, Lambert J, Almallah WR, Becker R, de las Fuentes L, Bakas T. A randomized feasibility trial of the Midlife Black Women's Stress and Wellness intervention (B-SWELL); a community participatory intervention to increase adoption of Life's Simple 7 healthy lifestyle behaviors. Transl Behav Med 2022; 12:1084-1095. [PMID: 36208220 PMCID: PMC9677463 DOI: 10.1093/tbm/ibac075] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Black women have a disproportionately higher incidence of cardiovascular disease-related mortality than other groups, yet they are less likely to receive culturally proficient education and competent preventive care. PURPOSE The purpose of this study was to determine feasibility of the Midlife Black Women's Stress and Wellness intervention (B-SWELL); a culturally adapted, 8-week group intervention leveraging stress reduction and goal setting to increase awareness and adoption of Life's Simple 7 (LS7) healthy lifestyle behaviors. METHODS A randomized feasibility trial was conducted. Participants (N = 48, mean age = 55 years) were randomized to the B-SWELL or a group wellness (WE) intervention that lacked stress reduction and goal setting instruction. We hypothesized that B-SWELL participants would achieve a lower perceived stress, greater self-efficacy, improved LS7 scores, fewer symptoms (depression and unhealthy days), and greater perceived general health compared to WE participants. Survey data were collected at three timepoints: baseline, 8 weeks, and 12 weeks. RESULTS Both B-SWELL and WE groups had low attrition and navigated the online platform well. Further, both groups experienced lower perceived stress, improved LS7 scores, reduced depressive symptoms, and greater perceived general health from baseline to 8 weeks. Based on data trends, participants in the B-SWELL had more improvement in perceived stress, self-efficacy, and mental and physical unhealthy days compared to WE participants. CONCLUSION The B-SWELL is a feasible intervention for midlife Black women. Positive data trends were found for both B-SWELL and WE groups. Based on observations from the feasibility study, a larger outcomes-based study is planned.
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Affiliation(s)
- Holly J Jones
- Ohio State University College of Nursing Martha S. Pitzer Center for Women, Children, and Youth, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Melinda Butsch Kovacic
- University of Cincinnati College of Allied Health Sciences 3225 Eden Ave, Cincinnati, OH 45267, USA
- Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA
- University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA
| | - Joshua Lambert
- University of Cincinnati College of Nursing, 3110 Vine Street, Cincinnati, OH 45221, USA
| | - Wala’a R Almallah
- University of Cincinnati College of Nursing, 3110 Vine Street, Cincinnati, OH 45221, USA
| | - Richard Becker
- University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA
| | - Lisa de las Fuentes
- Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63110, USA
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, 3110 Vine Street, Cincinnati, OH 45221, USA
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17
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Seibert T, Schroeder MW, Perkins AJ, Park S, Batista-Malat E, Head KJ, Bakas T, Boustani M, Fowler NR. The Impact of the COVID-19 Pandemic on the Mental Health of Older Primary Care Patients and Their Family Members. J Aging Res 2022; 2022:6909413. [PMID: 36285190 PMCID: PMC9588361 DOI: 10.1155/2022/6909413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/07/2022] [Indexed: 11/30/2023] Open
Abstract
The COVID-19 pandemic introduced mandatory stay-at-home orders and concerns about contracting a virus that impacted the physical and mental health of much of the world's population. This study compared the rates of depression and anxiety in a sample of older primary care patients (aged ≥65 years old) and their family members recruited for a clinical trial before and during the COVID-19 pandemic. Participants were dyads enrolled in the Caregiver Outcomes of Alzheimer's Disease Screening (COADS) trial, which included 1,809 dyads of older primary care patients and one of their family members. Mean scores on the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Scale-7 (GAD-7) were measured and compared before and during the pandemic. We found no difference in depression and anxiety among dyads of older primary care patients and their family members recruited before and during COVID-19. Additionally, we found that older primary care patients and family members who reported their income as comfortable had significantly lower depression and anxiety compared to those who reported having not enough to make ends meet. Along with this, older primary care patients with a high school education or less were more likely to have anxiety compared to those with a postgraduate degree. Moreover, our findings support the notion that certain demographics of older primary care patients and family members are at a higher risk for depression and anxiety, indicating who should be targeted for psychological health interventions that can be adapted during COVID-19. Future research should continue monitoring older primary care patients and their family members through the remainder of the COVID-19 pandemic.
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Affiliation(s)
- Tara Seibert
- Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Matthew W. Schroeder
- Indiana University Center for Aging Research, Indianapolis, IN 46202, USA
- Regenstrief Institute Inc., Indianapolis, IN 46202, USA
| | - Anthony J. Perkins
- Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Department of Biostatistics and Health Data Science, Indianapolis, IN 46202, USA
| | - Seho Park
- Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Department of Biostatistics and Health Data Science, Indianapolis, IN 46202, USA
| | - Eleanor Batista-Malat
- Indiana University Center for Aging Research, Indianapolis, IN 46202, USA
- Regenstrief Institute Inc., Indianapolis, IN 46202, USA
| | - Katharine J. Head
- Indiana University-Purdue University Indianapolis, Department of Communication Studies, Indianapolis, IN 46202, USA
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, Cincinnati, OH 45219, USA
| | - Malaz Boustani
- Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Indiana University Center for Aging Research, Indianapolis, IN 46202, USA
- Regenstrief Institute Inc., Indianapolis, IN 46202, USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis 46202, USA
| | - Nicole R. Fowler
- Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Indiana University Center for Aging Research, Indianapolis, IN 46202, USA
- Regenstrief Institute Inc., Indianapolis, IN 46202, USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis 46202, USA
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18
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Abstract
BACKGROUND A paucity of studies describes the prevalence of family-centered care (FCC) practices and resources in US neonatal units. PURPOSE To identify US prevalence of FCC practices and resources and to identify the largest gaps in resource provision. METHODS Neonatal nurses completed an online survey through national conferences (eg, NANN educational conference), neonatal organization Web sites (eg, NANN research survey), and social media (eg, NANN and NPA Facebook). Nurses provided demographics and the National Perinatal Association Self-Assessment on Comprehensive Family Support, a 61-item checklist of FCC practices and resources from 6 categories: family-centered developmental care, staff education/support, peer support, palliative care, discharge education, and mental health support. RESULTS Nurses (n = 103) reported lowest resources for Peer Support and Mental Health Support. About a third had a neonatal intensive care unit parent advisory committee (n = 39; 37.9%). Only 43.7% (n = 45) had necessary amenities for families to stay with their infants. Less than a third felt that mental health professionals were adequately staffed to provide counseling to parents (n = 28; 27.5%). Very few nurses had adequate training on providing parents psychological support (n = 16; 15.8%). More than half (n = 58; 56.3%) stated that all staff receive training in family-centered developmental care. Finally, less than half (n = 42; 40.8%) stated that staff see parents as equal members of the care team. IMPLICATIONS FOR PRACTICE We demonstrate a consistent and widespread lack of training provided to neonatal staff in nearly every aspect of comprehensive FCC support. IMPLICATIONS FOR RESEARCH Researchers need to identify unit/organizational interventions that increase adoption and implementation of FCC practices and resources.
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Affiliation(s)
- Ashley Weber
- University of Cincinnati, College of Nursing, Cincinnati, Ohio (Drs Weber and Bakas); University of Cincinnati, College of Medicine, Cincinnati, Ohio (Dr Kaplan); Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Kaplan and Ms Elder); James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Drs Weber and Kaplan); University Hospitals Cleveland Medical Center, Rainbow Babies & Children's Hospital, Highland Hills, Ohio (Drs Weber and Voos); Case Western Reserve University, School of Medicine, Cleveland, Ohio (Dr Voos and Ms Close); The Ohio State University, College of Nursing, Columbus (Dr Tubbs-Cooley); The Ohio State University, College of Medicine, Columbus (Dr Tubbs-Cooley); Nationwide Children's Hospital, Columbus, Ohio (Drs Weber and Tubbs-Cooley); and St John's Regional Medical Center, Oxnard, California (Dr Hall)
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19
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Abstract
ABSTRACT BACKGROUND: Stroke family caregivers were already struggling with unmet needs and changes in their own lives from providing care. The COVID-19 pandemic added further stress and disruption to their lives. The purpose of this study was to describe life changes in 17 stroke family caregivers specifically resulting from the COVID-19 pandemic. METHODS: This study was conducted as a secondary data analysis from an ongoing randomized controlled clinical trial testing feasibility of the Telehealth Assessment and Skill-Building Kit (TASK III). Using a multimethod design, both quantitative and qualitative data were analyzed to determine caregiver life changes. Quantitative ratings regarding life changes were obtained using 17 items adapted specifically for COVID-19 from the Bakas Caregiving Outcomes Scale. Rigorous content analysis procedures for the qualitative data were guided by a start list of codes based on the 17 items, with additional themes possible. Representative quotes were selected based on author consensus. RESULTS: Findings revealed both negative and positive life changes from the COVID-19 pandemic. Negative life changes included such things as disrupted daily routines, limited access to healthcare providers and resources (eg, food, masks, hand sanitizers), reduced family and social contact and activities, decreased emotional well-being, and problems with performing caregiving activities for the survivor. Positive life changes were increased use of the Internet and videoconferencing, closer relationships with friends, and learning how to access needed resources in new ways. CONCLUSION: Stroke family caregivers experienced both negative and positive life changes specifically as a result of the COVID-19 pandemic. Responses further indicated that COVID-19 affected most caregivers in different ways and an individualized approach is needed in dealing with caregiver life changes.
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20
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Abstract
Stroke family caregiver and dyad literature has expanded over the past few years. The purpose of this review was to build upon 2 prior systematic reviews to critique, analyze, and synthesize the evidence pertaining to the impact of family caregiver and dyad interventions on stroke survivor and family caregiver outcomes. CINAHL, PsychINFO, PubMed, and reference lists were searched from December 1, 2016 through March 31, 2021. Using PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), articles were identified that tested outcomes from stroke family caregiver or dyad interventions that targeted the health or well-being of family caregivers. Data from the articles were abstracted into tables for analysis, then compared with recommendations from the 2 prior systematic reviews. A total of 18 articles met inclusion criteria (10 caregiver interventions; 8 dyad interventions) representing sample sizes ranging from 7 to 349 caregivers or dyads. Most were randomized controlled trials (n=13); 2 were cluster randomized trials; and 3 were single-group quasi-experimental designs. Of the 18 studies, 8 had <50 caregivers or dyads and 5 were small feasibility studies that reported data trends rather than testing for significance. Only 6 studies reported significant survivor outcomes. Eleven studies reported significant caregiver outcomes, the most common being burden. A number of survivor and caregiver outcomes were not significant, or only significant for certain subgroups. The limited number of studies, small sample sizes, and conflicting results, made it difficult to draw firm conclusions regarding the impact of these interventions on outcomes. Based on the available evidence from these 18 studies, recommendations from the 2 prior reviews were generally supported. Well-designed and well-powered randomized controlled clinical trials are still needed to confirm efficacy of stroke family caregiver and dyad interventions.
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Affiliation(s)
- Tamilyn Bakas
- University of Cincinnati College of Nursing, Cincinnati, OH
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21
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Head KJ, Hartsock JA, Bakas T, Boustani MA, Schroeder M, Fowler NR. Development of Written Materials for Participants in an Alzheimer's Disease and Related Dementias Screening Trial. J Patient Exp 2022; 9:23743735221092573. [PMID: 35434299 PMCID: PMC9009139 DOI: 10.1177/23743735221092573] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Given that participants' experiences in clinical trials include a variety of communication touchpoints with clinical trial staff, these communications should be designed in a way that enhances the participant experience by paying attention to the self-determination theoretical concepts of competence, autonomy, and relatedness. In this feature, we argue that clinical trial teams need to consider the importance of how they design their written participant communication materials, and we explain in detail the process our multidisciplinary team took to design written materials for the patient and family caregiver participants in our Alzheimer's disease and related dementias (ADRD) screening trial. This article concludes with suggested guidance and steps for other clinical trial teams.
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Affiliation(s)
- Katharine J Head
- Department of Communication Studies, Indiana University–Purdue University
Indianapolis, Indianapolis, IN, USA
| | - Jane A. Hartsock
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Malaz A Boustani
- Department of Medicine, Indiana University School of
Medicine, Indianapolis, IN, USA
- Indiana University Center for Aging Research, Indianapolis, IN,
USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational
Science Institute, USA
| | | | - Nicole R Fowler
- Department of Medicine, Indiana University School of
Medicine, Indianapolis, IN, USA
- Indiana University Center for Aging Research, Indianapolis, IN,
USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational
Science Institute, USA
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22
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Jones HJ, Bakas T, Nared S, Humphries J, Wijesooriya J, Butsch Kovacic M. Co-Designing a Program to Lower Cardiovascular Disease Risk in Midlife Black Women. Int J Environ Res Public Health 2022; 19:ijerph19031356. [PMID: 35162379 PMCID: PMC8835512 DOI: 10.3390/ijerph19031356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/11/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 11/16/2022]
Abstract
Midlife Black women suffer disproportionately from heart disease and stroke in comparison to White women of similar age and demographic. Risk for cardiovascular disease (CVD) and stroke is largely considered to be modifiable yet CVD prevention and awareness campaigns have been less effective among Black women. Decreased awareness of personal CVD risk is associated with delays in the presentation of women to the emergency room or health care providers for symptoms of myocardial infarction. The Midlife Black Women's Stress and Wellness (B-SWELL) program was designed to increase awareness about CVD risk factors, stress, and healthy lifestyle behaviors among midlife Black women. In partnership with an existing Community Research Advisory Board (C-RAB), materials were developed and culturally adapted for the B-SWELL program. Following successful development of the B-SWELL materials, a trial of the B-SWELL program was conducted with a sample of midlife Black women recruited from the community. The program was co-facilitated by members of the C-RAB. We outline the strategies used to successfully co-create and trial the B-SWELL program materials and reflect on the strengths and challenges associated with the development of a culturally tailored heart disease prevention program using community participatory methods.
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Affiliation(s)
- Holly J. Jones
- College of Nursing, University of Cincinnati, Cincinnati, OH 45267, USA;
- Correspondence: ; Tel.: +1-513-558-5285
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH 45267, USA;
| | - Sheila Nared
- West End Community Research Advisory Board, Cincinnati, OH 45214, USA; (S.N.); (J.H.); (M.B.K.)
- Seven Hills Neighborhood Houses, Cincinnati, OH 45214, USA;
| | - Jacqueline Humphries
- West End Community Research Advisory Board, Cincinnati, OH 45214, USA; (S.N.); (J.H.); (M.B.K.)
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Julie Wijesooriya
- Seven Hills Neighborhood Houses, Cincinnati, OH 45214, USA;
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Melinda Butsch Kovacic
- West End Community Research Advisory Board, Cincinnati, OH 45214, USA; (S.N.); (J.H.); (M.B.K.)
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH 45267, USA
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23
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Bakas T, Miller EL. Family Caregiving across the Lifespan and Conditions: Special Issue on Family Caregiving. West J Nurs Res 2021; 44:203-204. [PMID: 34873985 DOI: 10.1177/01939459211064029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Almojaibel AA, Munk N, Goodfellow LT, Fisher TF, Miller KK, Comer AR, Bakas T, Justiss MD. Determinants of Telerehabilitation Acceptance among Patients Attending Pulmonary Rehabilitation Programs in the United States. Saudi J Med Med Sci 2021; 9:230-234. [PMID: 34667469 PMCID: PMC8473997 DOI: 10.4103/sjmms.sjmms_10_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/28/2021] [Accepted: 07/12/2021] [Indexed: 11/26/2022]
Abstract
Background: Pulmonary rehabilitation (PR) is an interdisciplinary intervention designed to improve the physical status and the psychological condition of people with chronic respiratory diseases. To improve patients' participation in PR programs, telerehabilitation has been introduced. Objective: This study aimed to identify factors that could influence the intention to use telerehabilitation among patients attending traditional PR programs. Methods: This cross-sectional study recruited subjects attending the PR centers in the hospitals of the Indiana State University, United States of America, between January and May 2017. Data were collected using self-administered Tele-Pulmonary Rehabilitation Acceptance Scale (TPRAS). TPRAS had two subscales: perceived usefulness and perceived ease of use. Behavioral intention (BI) was the dependent variable, and all responses were dichotomized into positive and negative intention to use. Multiple logistic regressions were performed to assess the influence of variables on the intention to use telerehabilitation. Results: A total of 134 respondents were included in this study, of which 61.2% indicated positive intention to use telerehabilitation. Perceived usefulness was a significant predictor of the positive intentions to use of telerehabilitation. Duration of respiratory disease was negatively associated with the use of telerehabilitation. Conclusion: Perceived usefulness was a significant predictor of using telerehabilitation. The findings of this study may be useful for health-care organizations in improving the adoption of telerehabilitation or in its implementation. Future telerehabilitation acceptance studies could explore the effects of additional factors including computer literacy and culture on the intention to use telerehabilitation.
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Affiliation(s)
- Abdullah A Almojaibel
- Department of Respiratory Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Niki Munk
- Department of Health Sciences, School of Health and Human Sciences, Indiana University, Indianapolis, IN, USA
| | - Lynda T Goodfellow
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA
| | - Thomas F Fisher
- Department of Health Sciences, Vera Z. Dwyer College of Health Sciences, Indiana University, South Bend, IN, USA
| | - Kristine K Miller
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, USA
| | - Amber R Comer
- Department of Health Sciences, School of Health and Human Sciences, Indiana University, Indianapolis, IN, USA
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Michael D Justiss
- Department of Occupational Therapy, Brooks Rehabilitation College of Healthcare Sciences, Jacksonville University, Jacksonville, FL, USA
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25
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Abstract
Lewy body disease (LBD) is a devastating condition with cognitive and physical deficits that pose a challenge to family caregivers. The purpose of this study was to identify the needs and concerns of family caregivers of persons with LBD. A convenience sample of LBD caregivers were interviewed regarding their caregiving needs, concerns, strategies, and advice. A content analysis approach was used to organize data into themes from an existing needs and concerns framework. Findings included the need for more information about the disease, strategies for managing LBD-related emotions and behaviors, support and assistance with physical and instrumental care, and strategies for managing one's own personal responses to caregiving. Findings highlight the need for a Lewy body specific caregiver assessment tool and future caregiver interventions.
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Affiliation(s)
- Kelly E Stacy
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Joseph Perazzo
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Rhonna Shatz
- Department of Neurology and Rehabilitation, University of Cincinnati, Cincinnati, OH, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
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26
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Abstract
Stroke family caregivers often neglect their own health while providing care. Rigorous reviews have focused on stroke caregiver needs and outcomes; however, a comprehensive review of stroke caregiver health is lacking. The purpose of this integrative review was to determine factors associated with stroke family caregiver health. Using a PRISMA flow diagram and Rayyan software, 41 studies were identified published from January 2000 to December 2020. Databases included Cochrane Reviews, Cochrane Trials, PsycINFO, Ovid MEDLINE, PubMed, EBSCOhost MEDLINE, Embase, and CINAHL. Rigorous guidelines were used to critique the 41 articles. Health measures were global in nature, lacking details regarding health promotion activities important to stroke family caregiver health. Common factors associated with caregiver health were depressive symptoms and burden. Further research is needed to design more situation-specific instruments to measure stroke family caregiver health, as well as interventions to reduce depressive symptoms and burden while promoting caregiver health.
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Affiliation(s)
- Cleopatra Kum
- University of Cincinnati, College of Nursing, Cincinnati, OH, USA
| | - Elaine L Miller
- University of Cincinnati, College of Nursing, Cincinnati, OH, USA
| | - Holly Jones
- University of Cincinnati, College of Nursing, Cincinnati, OH, USA
| | - Emily B Kean
- University of Cincinnati, Health Sciences Library, Cincinnati, OH, USA
| | - Natalie Kreitzer
- University of Cincinnati, Department of Emergency Medicine, Cincinnati, OH, USA
| | - Tamilyn Bakas
- University of Cincinnati, College of Nursing, Cincinnati, OH, USA
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Chrysouli MP, Banti CN, Kourkoumelis N, Moushi EE, Tasiopoulos AJ, Douvalis A, Papachristodoulou C, Hatzidimitriou AG, Bakas T, Hadjikakou SK. Ciprofloxacin conjugated to diphenyltin(IV): a novel formulation with enhanced antimicrobial activity. Dalton Trans 2021; 49:11522-11535. [PMID: 32656556 DOI: 10.1039/d0dt01665a] [Citation(s) in RCA: 9] [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: 12/20/2022]
Abstract
The metalloantibiotic of formula Ph2Sn(CIP)2 (CIPTIN) (HCIP = ciprofloxacin) was synthesized by reacting ciprofloxacin hydrochloride (HCIP·HCl) (an antibiotic in clinical use) with diphenyltin dichloride (Ph2SnCl2DPTD). The complex was characterized in the solid state by melting point, FT-IR, X-ray Powder Diffraction (XRPD) analysis, 119Sn Mössbauer spectroscopy, X-ray Fluorescence (XRF) spectroscopy, and Thermogravimetry/Differential Thermal Analysis (TG-DTA) and in solution by UV-Vis, 1H NMR spectroscopic techniques and Electrospray Ionisation Mass Spectrometry (ESI-MS). The crystal structure of CIPTIN and its processor HCIP was also determined by X-ray crystallography. The antibacterial activity of CIPTIN, HCIP·HCl, HCIP and DPTD was evaluated against the bacterial species Pseudomonas aeruginosa (P. aeruginosa), Escherichia coli (E. coli), Staphylococcus aureus (S. aureus) and Staphylococcus epidermidis (S. epidermidis), by the means of Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) and Inhibition Zones (IZs). CIPTIN shows lower MIC values than those of HCIP·HCl (up to 4.2-fold), HCIP (up to 2.7-fold) or DPTD (>135-fold), towards the tested microbes. CIPTIN is classified into bactericidal agents according to MBC/MIC values. The developing IZs are 40.8 ± 1.5, 34.0 ± 0.8, 36.0 ± 1.1 and 42.7 ± 0.8 mm, respectively which classify the microbes P. aeruginosa, E. coli, S. aureus and S. epidermidis to susceptible ones to CIPTIN. These IZs are greater than the corresponding ones of HCIP·HCl by 1.1 to 1.5-fold against both the tested Gram negative and Gram positive bacteria. CIPTIN eradicates the biofilm of P. aeruginosa and S. aureus more efficiently than HCIP·HCl and HCIP. The in vitro toxicity and genotoxicity of CIPTIN were tested against human skin keratinocyte cells (HaCaT) (IC50 = 2.33 μM). CIPTIN exhibits 2 to 9-fold lower MIC values than its IC50 against HaCaT, while its genotoxic effect determined by micronucleus assay is equivalent to the corresponding ones of HCIP·HCl or HCIP.
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Affiliation(s)
- M P Chrysouli
- Inorganic and Analytical Chemistry, Department of Chemistry, University of Ioannina, 45110 Ioannina, Greece.
| | - C N Banti
- Inorganic and Analytical Chemistry, Department of Chemistry, University of Ioannina, 45110 Ioannina, Greece.
| | - N Kourkoumelis
- Medical Physics Laboratory, Medical School, University of Ioannina, Ioannina, Greece
| | - E E Moushi
- Department of Life Sciences, The School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - A J Tasiopoulos
- Department of Chemistry, University of Cyprus, 1678 Nicosia, Cyprus
| | - A Douvalis
- Mössbauer Spectroscopy and Physics of Material Laboratory, Department of Physics, University of Ioannina, Ioannina, Greece
| | | | - A G Hatzidimitriou
- Department of Chemistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - T Bakas
- Mössbauer Spectroscopy and Physics of Material Laboratory, Department of Physics, University of Ioannina, Ioannina, Greece
| | - S K Hadjikakou
- Inorganic and Analytical Chemistry, Department of Chemistry, University of Ioannina, 45110 Ioannina, Greece. and University Research Center of Ioannina (URCI), Institute of Materials Science and Computing, Ioannina, Greece
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McCarthy MJ, Sanchez A, Garcia YE, Bakas T. A systematic review of psychosocial interventions for Latinx and American Indian patient-family caregiver dyads coping with chronic health conditions. Transl Behav Med 2021; 11:1639-1654. [PMID: 34037222 DOI: 10.1093/tbm/ibab051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/12/2022] Open
Abstract
Latinx and American Indians experience high rates of chronic health conditions. Family members play a significant role as informal caregivers for loved ones with chronic conditions and both patients and family caregivers report poor psychosocial outcomes. This systematic review synthesizes published studies about psychosocial interventions for Latinx and American Indian care dyads to determine: (i) the benefits of these interventions; (ii) their distinguishing features or adaptations, and; (iii) recommendations for future intervention development. Out of 366 records identified, seven studies met inclusion criteria. Interventions demonstrated benefits to outcomes such as disease knowledge, caregiver self-efficacy and burden, patient and caregiver well-being, symptom distress, anxiety and depression, and dyadic communication. Distinguishing features included tailoring to cultural values, beliefs, and delivery preferences, participants' level of acculturation, and population-specific issues such as migratory stressors and support networks. Based upon this review, six recommendations for future intervention development are put forth.
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Affiliation(s)
- Michael J McCarthy
- Department of Social Work, College of Social and Behavioral Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Angelica Sanchez
- Department of Sociology, College of Social and Behavioral Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Y Evie Garcia
- Department of Educational Psychology, College of Education, Northern Arizona University, Arizona, Flagstaff, AZ, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
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Affiliation(s)
- Tamilyn Bakas
- University of Cincinnati College of Nursing, OH (T.B.)
| | - Patricia Commiskey
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN (P.C.)
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McCarthy M, Sanchez A, Garcia YE, Dunn D, Williamson H, Baldwin J, Hustead MLR, Bakas T. Systematic Review of Interventions for LatinX and American Indian Family Dyads Coping With Chronic Illness. Innov Aging 2020. [PMCID: PMC7741405 DOI: 10.1093/geroni/igaa057.325] [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: 11/14/2022] Open
Abstract
Abstract
The United States is experiencing growth in populations from culturally diverse backgrounds. Studies suggest that Latinx and American Indians experience chronic conditions such as cancer, heart disease, and diabetes in greater numbers than whites. Literature also suggests that Latinx and American Indian families play a significant role as informal caregivers for loved ones with chronic illness. However, little information is available about interventions to assist these patient-family caregiver dyads cope. The purpose of this systematic review is to synthesize published studies about psychosocial interventions developed or adapted for Latinx and American Indian care dyads in order to determine: (1) the benefits of these interventions; (2) their distinguishing features or adaptations, and; (3) recommendations for future intervention development. The protocol for this review was registered in advance with the International Prospective Register of Systematic Reviews (PROSPERO). We searched the databases CINAHL, PsycINFO, MEDLINE, and PubMeb using MeSH-derived keywords developed in consultation with a research librarian. Studies were included/excluded based upon pre-specified criteria. Three-hundred thirty-five records were identified, screened by the research team, and tracked according to PRISMA guidelines. After removing duplicates (n=9), studies that did not pertain to the conditions of interest (n=13), and studies that did not meet inclusion criteria (n=305), eight studies remained. Relevant information was abstracted from the final studies and synthesized by the research team. The majority of interventions for these populations are in cancer. Findings about benefits are largely inconclusive. Adaptations include a focus on cultural contexts, as well as culturally-based strengths, caregiving norms, and values.
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Affiliation(s)
| | | | | | - Dorothy Dunn
- Northern Arizona University, Flagstaff, Arizona, United States
| | | | - Julie Baldwin
- Northern Arizona University, Flagstaff, Arizona, United States
| | | | - Tamilyn Bakas
- Northern Arizona University, Flagstaff, Arizona, United States
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McCarthy M, Garcia YE, Lyons K, Sanchez A, Bakas T. Feasibility Test of a Customizable Relationship Intervention for Stroke Survivor-Family Caregiver Dyads. Innov Aging 2020. [PMCID: PMC7740447 DOI: 10.1093/geroni/igaa057.1205] [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
A strong interpersonal relationship after stroke is important for the well-being of survivors and family caregivers. However, few interventions are designed to strengthen the relationship between members of the care dyad in order to prevent depression and other poor outcomes. The aim of this study was to feasibility test a quality of relationship intervention for stroke dyads called Hand in Hand (HiH). Sixteen survivor-caregiver dyads were recruited and randomized into either the HiH intervention group (n=8) or the Information, Support, and Referral (ISR) control group (n=8). HiH dyads received up to 8 sessions with a social worker in-person, by telephone, or by Zoom web conference, prioritized according to a 17-item screening tool with 17 corresponding HiH content areas. ISR dyads received up to 8 sessions that included information, active listening, and referrals as needed. Process, satisfaction, and pre/post outcomes data were collected for both groups. Seventy-five percent of HiH dyads completed over half the sessions which lasted, on average, 55 minutes (range 26-76). Sixty-two percent of ISR dyads completed over half the sessions which lasted, on average, 21 minutes (range 15-33). Dyads in both groups reported being satisfied with the program materials and processes. Survivors and caregivers in both groups experienced improvements in outcomes, particularly caregivers in the HiH group who showed improvements in communication, coping, subjective relationship quality, and depressive symptoms. Findings suggest that HiH is feasible to implement with stroke dyads and has promise for improving outcomes for participants. Additional research is needed to determine program efficacy.
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Affiliation(s)
| | | | - Karen Lyons
- Boston College, Chestnut Hill, Massachusetts, United States
| | | | - Tamilyn Bakas
- University of Cincinati, Cincinnati, Ohio, United States
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Bakas T, McCarthy MJ, Israel J, Brehm BJ, Dunning K, Rota M, Turner M, Miller EL. Adapting the telephone assessment and skill‐building kit to the telehealth technology preferences of stroke family caregivers. Res Nurs Health 2020; 44:81-91. [DOI: 10.1002/nur.22075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/03/2020] [Accepted: 10/05/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Tamilyn Bakas
- University of Cincinnati College of Nursing Cincinnati Ohio USA
| | | | - Jahmeel Israel
- University of Cincinnati College of Nursing Cincinnati Ohio USA
| | - Bonnie J. Brehm
- University of Cincinnati College of Nursing Cincinnati Ohio USA
| | - Kari Dunning
- Department of Rehabilitation, Exercise and Nutrition Sciences University of Cincinnati College of Allied Health Sciences Cincinnati Ohio USA
| | - Matthew Rota
- University of Cincinnati College of Nursing Cincinnati Ohio USA
| | - Mickenna Turner
- University of Cincinnati College of Nursing Cincinnati Ohio USA
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Abstract
BACKGROUND PhotoVoice is a qualitative research methodology designed to engage and empower marginalized members of a community and/or to understand community needs. PhotoVoice seems aphasia-friendly because it relies on personal photographs to convey opinions regarding prespecified topics. However, PhotoVoice is based on a procedure referred to as the SHOWeD method. Participants are asked to reflect upon their photos by discussing (1) what they See, (2) what is Happening, (3) the relation to Our life, (3) Why the issue or condition exists, and then to (4) explain what can be Done to address the issue(s) at hand. Due to the linguistic demand required to convey complex thoughts and ideas inherent in this methodology, adaptations are likely required to successfully implement with people who have aphasia. AIMS A scoping review was conducted to summarize the current literature regarding the use of PhotoVoice with people who have aphasia, to address two questions:(1) Are people with post-stroke aphasia included in PhotoVoice studies?(2) What, if any, modifications are required to address post-stroke aphasia and motor impairments? MAIN CONTRIBUTION This scoping review revealed that researchers often exclude people with aphasia from post-stroke PhotoVoice research. Three studies outlined adaptations that allowed successful implementation with people who have post-stroke aphasia. CONCLUSIONS Further inquiry regarding how best to adapt PhotoVoice for people with aphasia will facilitate their ability to be included in community-based research. This is an important step in ensuring that all post-stroke stakeholders are involved in projects related to social justice and policy for stroke survivors.
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Affiliation(s)
- Aimee Dietz
- Department of Communication Sciences and Disorders, University of Cincinnati College of Allied Health Sciences, Cincinnati, OH, USA
| | - Chitrali R Mamlekar
- Department of Communication Sciences and Disorders, University of Cincinnati College of Allied Health Sciences, Cincinnati, OH, USA
| | | | - Michael J McCarthy
- College of Social and Behavioral Sciences, University of Northern Arizona, Flagstaff, AZ, USA
| | - Dana Harley
- School of Social Work, University of Cincinnati College of Allied Health Sciences, Cincinnati, OH, USA
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
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Almojaibel AA, Munk N, Goodfellow LT, Fisher TF, Miller KK, Comer AR, Bakas T, Justiss MD. Health Care Practitioners' Determinants of Telerehabilitation Acceptance. Int J Telerehabil 2020; 12:43-50. [PMID: 32983367 PMCID: PMC7502808 DOI: 10.5195/ijt.2020.6308] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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] [Indexed: 01/01/2023] Open
Abstract
Background: Pulmonary rehabilitation is a multidisciplinary patient-tailored intervention that aims to improve the physical and psychological condition of people with chronic respiratory diseases. Providing pulmonary rehabilitation (PR) services to the growing population of patients is challenging due to shortages in health care practitioners and pulmonary rehabilitation programs. Telerehabilitation has the potential to address this shortage in practitioners and PR programs as well as improve patients' participation and adherence. This study's purpose was to identify and evaluate the influences of intention of health care practitioners to use telerehabilitation. Methods: Data were collected through a self-administered Internet-based survey. Results: Surveys were completed by 222 health care practitioners working in pulmonary rehabilitation with 79% having a positive intention to use telerehabilitation. Specifically, perceived usefulness was a significant individual predictor of positive intentions to use telerehabilitation. Conclusion: Perceived usefulness may be an important factor associated with health care providers' intent to use telerehabilitation for pulmonary rehabilitation.
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Affiliation(s)
| | - Niki Munk
- School of Health and Human Sciences, Indiana University, Indianapolis, IN, USA
| | - Lynda T Goodfellow
- Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA
| | - Thomas F Fisher
- Dwyer College of Health Sciences, Iu South Bend, Indiana, USA
| | - Kristine K Miller
- School of Health and Human Sciences, Indiana University, Indianapolis, IN, USA
| | - Amber R Comer
- School of Health and Human Sciences, Indiana University, Indianapolis, IN, USA
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Michael D Justiss
- School of Applied Health Sciences, Brooks Rehabilitation College of Healthcare Sciences Jacksonville University, Jacksonville, FL, USA
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Fowler NR, Head KJ, Perkins AJ, Gao S, Callahan CM, Bakas T, Suarez SD, Boustani MA. Examining the benefits and harms of Alzheimer's disease screening for family members of older adults: study protocol for a randomized controlled trial. Trials 2020; 21:202. [PMID: 32075686 PMCID: PMC7031904 DOI: 10.1186/s13063-019-4029-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 12/23/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Multiple national expert panels have identified early detection of Alzheimer's disease and related dementias (ADRD) as a national priority. However, the United States Preventive Services Task Force (USPSTF) does not currently support screening for ADRD in primary care given that the risks and benefits are unknown. The USPSTF stresses the need for research examining the impact of ADRD screening on family caregiver outcomes. METHODS The Caregiver Outcomes of Alzheimer's Disease Screening (COADS) is a randomized controlled trial that will examine the potential benefits or harms of ADRD screening on family caregivers. It will also compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening. COADS will enroll 1800 dyads who will be randomized into three groups (n = 600/group): the 'Screening Only' group will receive ADRD screening at baseline and disclosure of the screening results, with positive-screen participants receiving a list of local resources for diagnostic follow-up; the 'Screening Plus' group will receive ADRD screening at baseline coupled with disclosure of the screening results, with positive-screen participants referred to a dementia collaborative care program for diagnostic evaluation and potential care; and the control group will receive no screening. The COADS trial will measure the quality of life of the family member (the primary outcome) and family member mood, anxiety, preparedness and self-efficacy (the secondary outcomes) at baseline and at 6, 12, 18 and 24 months. Additionally, the trial will examine the congruence of depressive and anxiety symptoms between older adults and family members at 6, 12, 18 and 24 months and compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening between the two groups randomized to screening (Screening Only versus Screening Plus). DISCUSSION We hypothesize that caregivers in the screening arms will express higher levels of health-related quality of life, lower depressive and anxiety symptoms, and better preparation for caregiving with higher self-efficacy at 24 months. Results from this study will directly inform the National Plan to Address Alzheimer's Disease, the USPSTF and other organizations regarding ADRD screening and early detection policies. TRIAL REGISTRATION ClinicalTrials.gov, NCT03300180. Registered on 3 October.
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Affiliation(s)
- Nicole R. Fowler
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202 USA
- Indiana University Center for Aging Research, Indianapolis, IN 46202 USA
- Regenstrief Institute, Inc., Indianapolis, IN 46202 USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis, IN 46202 USA
| | - Katharine J. Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202 USA
| | - Anthony J. Perkins
- Department of Biostatistics, Indiana University School of Medicine & Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202 USA
| | - Sujuan Gao
- Department of Biostatistics, Indiana University School of Medicine & Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202 USA
| | - Christopher M. Callahan
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202 USA
- Indiana University Center for Aging Research, Indianapolis, IN 46202 USA
- Regenstrief Institute, Inc., Indianapolis, IN 46202 USA
- Eskenazi Health, Indianapolis, IN 46202 USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH 45219 USA
| | - Shelley D. Suarez
- Indiana University Center for Aging Research, Indianapolis, IN 46202 USA
- Regenstrief Institute, Inc., Indianapolis, IN 46202 USA
| | - Malaz A. Boustani
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202 USA
- Indiana University Center for Aging Research, Indianapolis, IN 46202 USA
- Regenstrief Institute, Inc., Indianapolis, IN 46202 USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis, IN 46202 USA
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McCarthy MJ, Lyons KS, Schellinger J, Stapleton K, Bakas T. Interpersonal relationship challenges among stroke survivors and family caregivers. Soc Work Health Care 2020; 59:91-107. [PMID: 31964295 DOI: 10.1080/00981389.2020.1714827] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/23/2019] [Revised: 12/10/2019] [Accepted: 01/06/2020] [Indexed: 06/10/2023]
Abstract
A strong interpersonal relationship after stroke is important for the well-being of survivors and family caregivers. However, as many as 54% of families experience relationship problems after stroke and as many as 38% of couples experience overt conflict. The purpose of this study is to enhance understanding about relationship challenges among stroke dyads and to identify implications for direct practice in social work. Semi-structured interviews were conducted with N = 19 care dyads. Qualitative data were analyzed through an interpretive description lens. Seven themes about relationship challenges were identified. Findings highlight areas to consider in promoting strong relationships between survivors and family caregivers. Social workers may have the opportunity to assist dyads with disrupting negative communication cycles, strengthening empathy and collaboration, and achieving a balance so that each person's needs are met.
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Affiliation(s)
- Michael J McCarthy
- Department of Social Work, College of Social and Behavioral Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - Karen S Lyons
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Jeffrey Schellinger
- School of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - Katie Stapleton
- School of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
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Alhaj Ali A, Miller E, Ballman K, Bakas T, Geis G, Ying J. The impact of debriefing modalities on nurse practitioner students' knowledge and leadership skills in managing fatal dysrhythmias: A pilot study. Nurse Educ Pract 2019; 42:102687. [PMID: 31841811 DOI: 10.1016/j.nepr.2019.102687] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 07/09/2018] [Revised: 10/29/2019] [Accepted: 12/06/2019] [Indexed: 11/27/2022]
Abstract
Acute care nurse practitioners (ACNPs) require special training and educational preparation to meet their role expectations. Using high fidelity simulation with debriefing modalities is considered one of the innovative learning strategies in graduate nursing. No studies have investigated debriefing modalities in nurse practitioner programs specially ACNPs leadership skills. The purpose of this study was to examine the difference in students' knowledge, code team leader skills and self-efficacy using two debriefing modalities. A two group, pretest-posttest quasi-experimental design was used. Students were divided into video-assisted debriefing group vs. verbal debriefing following a simulation scenario of managing emergency codes. There were no significant differences between the two groups in knowledge acquisition/retention, leadership skills, and self-efficacy, but there was a significant difference in self-efficacy in both groups between two-time points. There was a general improvement in teams' performance. Students preferred verbal debriefing over video-assisted debriefing. The debriefing session plays an important role in graduate nursing education. Acute care nurse practitioners are lacking a formal leadership training to meet their advanced role. Nurse Educators, and simulation/debriefing leaders may benefit from our study results to develop a structured, formal curriculum and educational instruction focusing on acute care nurse practitioners' role change especially leading a resuscitation team.
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Affiliation(s)
- Abeer Alhaj Ali
- University of Cincinnati, College of Nursing, OH,USA, 4587 Wyndtree Drive #122, West Chester, OH, 45069, USA.
| | - Elaine Miller
- Professor of Nursing. University of Cincinnati, College of Nursing. Cincinnati, Ohio, 45221-0038, USA.
| | - Kathleen Ballman
- Associate Professor of Clinical Nursing. University of Cincinnati, College of Nursing. 3110 Vine Street Cincinnati, Ohio, 45221, USA.
| | - Tamilyn Bakas
- Professor and Jane E.Procter Endowed Chair. University of Cincinnati, College of Nursing.3110 Vine Street, Cincinnati, OH, 45221-0038, USA.
| | - Gary Geis
- Center for Simulation and Research Attending Physician, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati Department of Pediatrics, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA.
| | - Jun Ying
- Professor of Biostatistics and Director of the Masters of Public Health Program Department of Environmental Health, University of Cincinnati College of Medicine.Kettering Lab Building G06 Cincinnati, OH, 45267-0056, USA.
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McCarthy MJ, Garcia YE, Dunn DJ, Lyons KS, Bakas T. Development and validation of a quality of relationship intervention for stroke survivor-family caregiver dyads. Top Stroke Rehabil 2019; 27:305-315. [PMID: 31782683 DOI: 10.1080/10749357.2019.1690823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/06/2023]
Abstract
Background: The relationship between stroke survivors and family caregivers is critical for the well-being of both dyad members. Currently, there are few interventions targeted at dyads and focused on strengthening the relationship between survivors and family caregivers.Objectives: This study reports on the development of a customizable, strengths-based, relationship-focused intervention driven by the real-world experience and advice of stroke dyads. It also describes the "tips" that survivors and family caregivers offered for dealing with relationship challenges after stroke.Methods: Content of the intervention, including relationship tips, was derived from semi-structured interviews with N= 19 stroke dyads. A modified Delphi process with a national panel of 10 subject matter experts was used to evaluate and refine the content of the intervention and the associated screening tool.Results: Seventeen domains of relationship challenges and tips were identified. Consensus was reached among experts that the intervention content was relevant to the goal of helping survivors and family caregivers maintain a strong relationship after stroke; (2) clear from the perspective of stroke survivors and family caregivers who would be using it; (3) accurate with respect to the advice being offered, and; (4) useful for helping stroke survivors and family caregivers improve the quality of their relationship.Conclusions: This study extends the limited body of research about dyadic interventions after stroke. The next steps in this line of research include feasibility testing the intervention and evaluating its efficacy in a larger trial.
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Affiliation(s)
- Michael J McCarthy
- Department of Social Work, College of Social and Behavioral Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Y Evie Garcia
- Department of Educational Psychology, College of Education, Northern Arizona University, Flagstaff, AZ, USA
| | - Dorothy J Dunn
- School of Nursing, College of Health & Human Services, Northern Arizona University, Flagstaff, AZ, USA
| | - Karen S Lyons
- William F. Connell School of Nursing, Boston College, MA, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
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McCarthy MJ, Lyons K, Dunn D, Garcia Y, Bakas T. DEVELOPING A QUALITY-OF-RELATIONSHIP INTERVENTION FOR STROKE-SURVIVOR FAMILY CAREGIVER DYADS. Innov Aging 2019. [PMCID: PMC6840907 DOI: 10.1093/geroni/igz038.1036] [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: 11/13/2022] Open
Abstract
A strong interpersonal relationship after stroke is important for the well-being of survivors and family caregivers. At present, few interventions are specifically designed to strengthen the relationship between members of the care dyad. The aim of this study is to develop, validate, and pilot test a quality of relationship intervention for stroke dyads. This poster presents findings from the content validity phase of the study and includes “tips” that dyads offered for maintaining a strong relationship. Semi-structured interviews were conducted with N=19 dyads to solicit information about relationship problems and tips. These data were used to develop a 17-item relationship assessment questionnaire with 17 “tip sheets” corresponding to each item. A Delphi process was used to obtain feedback from a 10-member expert panel about the degree to which the questionnaire and each tip sheet was (1) relevant; (2) clear; (3) accurate, and; (4) useful. Expert agreement ranged for 80% to 100%. The final materials included tips for dealing with issues that arise when one or both partners experience communication, mobility, cognitive, or emotional issues; reaching agreement about different aspects of recovery; working together to meet each partners’ needs; adjusting to new roles after stroke; dealing with relationship problems that predated stroke, and; getting support from other family members, friends, peers, and professionals. Findings highlight areas to consider in promoting strong relationships in care dyads. Future research is needed to examine whether these materials can help to reduce stressful interactions for care dyads, promote dyadic coping, and improve overall relationship quality.
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Affiliation(s)
| | - Karen Lyons
- Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts, United States
| | - Dorothy Dunn
- Northern Arizona University, Flagsttaff, Arizona, United States
| | - Yolanda Garcia
- Northern Arizona University, Flagsttaff, Arizona, United States
| | - Tamilyn Bakas
- University of Cincinnati, Cincinnati, Ohio, United States
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Monahan PO, Kroenke K, Callahan CM, Bakas T, Harrawood A, Lofton P, Frye D, Draucker C, Stump T, Saliba D, Galvin JE, Keegan A, Austrom MG, Boustani M. Development and Feasibility of SymTrak, aMulti-domain Tool for Monitoring Symptoms of Older Adults in Primary Care. J Gen Intern Med 2019; 34:915-922. [PMID: 30912032 PMCID: PMC6544681 DOI: 10.1007/s11606-018-4772-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 03/01/2018] [Revised: 08/29/2018] [Accepted: 11/21/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND A clinically practical, brief, user-friendly, multi-domain self-report and caregiver-report tool is needed for tracking actionable symptoms in primary care for elderly patients with multiple chronic conditions (MCCs). OBJECTIVE Develop and assess usability, administration time, and internal reliability of SymTrak. DESIGN AND PARTICIPANTS Phase I: legacy instruments, content validity, analyses of existing data, focus groups (physicians, nurses, patients, informal caregivers), and Think Aloud interviews (patients, caregivers) were used to develop SymTrak. Phase II (pilot feasibility study): 81 (27 patient-caregiver dyads, 27 patients without an identified caregiver) participants were self-administered SymTrak in clinic. MAIN MEASURES SymTrak and demographic questions. KEY RESULTS Consistent themes emerged from phase I focus groups. Ambiguous wording was corrected with Think Aloud feedback. In phase II, patients and caregivers preferred circling words instead of numbers for item response options. SymTrak self-administration completion time in clinic was brief; mean was 2.4, 3.0, and 3.3 min for the finalized circlingwords version, respectively, for caregivers, dyadic patients, and patients without a caregiver; and the maximum was 6.2 min for any participant. Usability questionnaire ratings were high. Cronbach's alpha for the SymTrak 23-item total score was 0.86, 0.79, and 0.81 for caregivers, dyadic patients, and patients without a caregiver, respectively. CONCLUSIONS SymTrak demonstrates content validity, positive qualitative findings, high perceived usability, brief self-administered completion time, and good internal reliability.
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Affiliation(s)
- Patrick O Monahan
- Indiana University School of Medicine, Indianapolis, IN, USA. .,Indiana University School of Public Health, Indianapolis, IN, USA.
| | - Kurt Kroenke
- Indiana University School of Medicine, Indianapolis, IN, USA.,VA HSR&D Center for Health Information and Communication, Indianapolis, IN, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA
| | - Christopher M Callahan
- Indiana University School of Medicine, Indianapolis, IN, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA.,Indiana University Center for Aging Research, Indianapolis, IN, USA
| | - Tamilyn Bakas
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Amanda Harrawood
- Indiana University Center for Aging Research, Indianapolis, IN, USA
| | - Phillip Lofton
- Indiana University Center for Aging Research, Indianapolis, IN, USA
| | - Danielle Frye
- Indiana University Center for Aging Research, Indianapolis, IN, USA
| | | | - Timothy Stump
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Debra Saliba
- University of California Borun Center and Veterans Administration, Los Angeles, CA, USA
| | - James E Galvin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Amanda Keegan
- Indiana University Center for Aging Research, Indianapolis, IN, USA
| | - Mary G Austrom
- Indiana University Department of Psychiatry, Indianapolis, IN, USA
| | - Malaz Boustani
- Indiana University School of Medicine, Indianapolis, IN, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA.,Indiana University Center for Aging Research, Indianapolis, IN, USA
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Monahan PO, Kroenke K, Callahan CM, Bakas T, Harrawood A, Lofton P, Frye D, Draucker C, Stump T, Saliba D, Galvin JE, Keegan A, Austrom MG, Boustani M. Reliability and Validity of SymTrak, a Multi-Domain Tool for Monitoring Symptoms of Older Adults with Multiple Chronic Conditions. J Gen Intern Med 2019; 34:908-914. [PMID: 31001721 PMCID: PMC6544736 DOI: 10.1007/s11606-018-4780-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 05/02/2018] [Revised: 09/18/2018] [Accepted: 11/27/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND A reliable and valid clinically practical multi-domain self-report and caregiver-report tool is needed for tracking actionable symptoms in primary care for elderly patients with multiple chronic conditions (MCCs). OBJECTIVE Assess internal consistency reliability, test-retest reliability, construct validity, and sensitivity to change for SymTrak. DESIGN AND PARTICIPANTS Among 600 (200 patient-caregiver dyads, 200 patients without an identified caregiver) participants, SymTrak was telephone interviewer-administered at baseline and 3-month follow-up, and at 24 h post-baseline for assessing test-retest reliability in a random subsample of 180 (60 dyads, 60 individual patients) participants. MAIN MEASURES Demographic questions, SymTrak, Health Utility Index Mark 3 (HUI3). KEY RESULTS Exploratory factor analysis indicated a single dominant dimension for SymTrak items for both patients and caregivers. Coefficient alpha and 24-h test-retest reliability, respectively, were high for the 23-item SymTrak total score for both patient-reported (0.85; 0.87) and caregiver-reported (0.86; 0.91) scores. Construct validity was supported by monotone decreasing relationships between the mean of SymTrak total scores across the poor-to-excellent categories of physical and emotional general health, and by high correlations with HUI3 overall utility score, even after adjusting for demographic covariates (standardized linear regression coefficient = - 0.84 for patients; - 0.70 for caregivers). Three-month change in the SymTrak total score was sensitive to detecting criterion standard 3-month reliable change categories (Improved, Stable, Declined) in HUI3-based health-related quality of life, especially for caregiver-reported scores. CONCLUSIONS SymTrak demonstrates good internal consistency and test-retest reliability, construct validity, and sensitivity to change over a 3-month period, supporting its use for monitoring symptoms for older adults with MCCs.
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Affiliation(s)
- Patrick O Monahan
- School of Medicine, Indiana University, Indianapolis, IN, USA. .,School of Public Health, Indiana University, Indianapolis, IN, USA.
| | - Kurt Kroenke
- School of Medicine, Indiana University, Indianapolis, IN, USA.,Center for Health Information and Communication, VA HSR&D, Washington, DC, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA
| | - Christopher M Callahan
- School of Medicine, Indiana University, Indianapolis, IN, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA.,Center for Aging Research, Indiana University, Indianapolis, IN, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, CA, USA
| | - Amanda Harrawood
- Center for Aging Research, Indiana University, Indianapolis, IN, USA
| | - Phillip Lofton
- Center for Aging Research, Indiana University, Indianapolis, IN, USA
| | - Danielle Frye
- Center for Aging Research, Indiana University, Indianapolis, IN, USA
| | - Claire Draucker
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | - Timothy Stump
- School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Debra Saliba
- Borun Center and Veterans Administration Los Angeles, University of California, Los Angeles, CA, USA
| | - James E Galvin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Amanda Keegan
- Center for Aging Research, Indiana University, Indianapolis, IN, USA
| | - Mary G Austrom
- Department of Psychiatry, Indiana University, Indianapolis, IN, USA
| | - Malaz Boustani
- School of Medicine, Indiana University, Indianapolis, IN, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA.,Center for Aging Research, Indiana University, Indianapolis, IN, USA
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Almojaibel AA, Munk N, Goodfellow LT, Fisher TF, Miller KK, Comer AR, Bakas T, Justiss MD. Development and Validation of the Tele-Pulmonary Rehabilitation Acceptance Scale. Respir Care 2019; 64:1057-1064. [PMID: 30914488 DOI: 10.4187/respcare.06432] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Using telehealth in pulmonary rehabilitation (telerehabilitation) is a new field of health-care practice. To successfully implement a telerehabilitation program, measures of acceptance of this new type of program need to be assessed among potential users. The purpose of this study was to develop a scale to measure acceptance of using telerehabilitation by health-care practitioners and patients. METHODS Three objectives were met (a) constructing a modified scale of the technology acceptance model, (b) judging the items for content validity, and (c) judging the scale for face validity. Nine experts agreed to participate and evaluate item relevance to theoretical definitions of domains. To establish face validity, 7 health-care practitioners and 5 patients were interviewed to provide feedback about the scale's clarity and ease of reading. RESULTS The final items were divided into 2 scales that reflected the health-care practitioner and patient responses. Each scale included 3 subscales: perceived usefulness, perceived ease of use, and behavioral intention. CONCLUSIONS The 2 scales, each with 3 subscales, exhibited evidence of content validity and face validity. The 17-item telerehabilitation acceptance scale for health-care practitioners and the 13-item telerehabilitation acceptance scale among patients warrant further psychometric testing as valuable measures for pulmonary rehabilitation programs.
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Affiliation(s)
- Abdullah A Almojaibel
- Department of Respiratory Care, College of Applied Medical Sciences, University of Imam Abdulrahman bin Faisal, Dammam, Saudi Arabia.
| | - Niki Munk
- Department of Health Sciences, School of Health and Rehabilitation Sciences, Indiana University, School of Health and Rehabilitation Sciences, Indianapolis, Indiana
| | - Lynda T Goodfellow
- Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia
| | - Thomas F Fisher
- Dwyer College of Health Sciences, IU South Bend, South Bend, Indiana
| | - Kristine K Miller
- Physical Therapy Program, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, Indiana
| | - Amber R Comer
- Health Sciences, Indiana University, Indianapolis, Indiana
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, Cincinnati, Ohio
| | - Michael D Justiss
- Department of Occupational Therapy, School of Applied Health Sciences, Brooks Rehabilitation College of Healthcare Sciences, Jacksonville University, Jacksonville, Florida
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Chung SY, Hacker ED, Rawl S, Ellis R, Bakas T, Jones J, Welch J. Using Facebook in Recruiting Kidney Transplant Recipients for a REDCap Study. West J Nurs Res 2019; 41:1790-1812. [PMID: 30836840 DOI: 10.1177/0193945919832600] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This web-based study recruited kidney transplant recipients from Facebook using three recruiting methods over a 5-week period. Participants completed 125 survey items via REDCap (Research Electronic Data Capture) survey. Facebook recruitment generated 153 eligible participants who completed surveys. The average survey response time was 15.07 min (SD = 6.12; range: 4-43), with a low missing item rate (<5%). Facebook's standard ads were most effective for recruiting subjects (n = 78, 51%), followed by three targeted Facebook kidney transplant support groups (n = 52, 34%) and a pay-to-promote study page (n = 12, 7.8%). The average cost paid for each valid survey was US$2.19 through standard Facebook ads and US$2.92 from the study page. The cost for online survey completion is economically feasible even for those with limited funds. Issues related to online surveys including extreme survey response times and participant misrepresentation were reported in this study.
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Affiliation(s)
- Shu-Yu Chung
- Indiana University-Purdue University Indianapolis, USA
| | | | - Susan Rawl
- Indiana University-Purdue University Indianapolis, USA
| | - Rebecca Ellis
- Indiana University-Purdue University Indianapolis, USA
| | | | - Josette Jones
- Indiana University-Purdue University Indianapolis, USA
| | - Janet Welch
- Indiana University-Purdue University Indianapolis, USA
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McCarthy M, Lyons K, Schellinger J, Stapleton K, Bakas T. INTERPERSONAL RELATIONSHIP CHALLENGES AMONG STROKE SURVIVORS AND FAMILY CAREGIVERS. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3567] [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: 11/12/2022] Open
Affiliation(s)
- M McCarthy
- College of Social and Behavioral Sciences - Social Work
| | | | | | | | - T Bakas
- . University of Cincinnati - College of Nursing
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Bakas T, Sampsel D, Israel J, Chamnikar A, Ellard A, Clark JG, Ulrich MG, Vanderelst D. Satisfaction and Technology Evaluation of a Telehealth Robotic Program to Optimize Healthy Independent Living for Older Adults. J Nurs Scholarsh 2018; 50:666-675. [DOI: 10.1111/jnu.12436] [Citation(s) in RCA: 12] [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] [Indexed: 12/21/2022]
Affiliation(s)
- Tamilyn Bakas
- University of Cincinnati College of Nursing Cincinnati OH USA
| | - Debi Sampsel
- University of Cincinnati College of Nursing Cincinnati OH USA
| | - Jahmeel Israel
- University of Cincinnati College of Nursing Cincinnati OH USA
| | - Ameya Chamnikar
- University of Cincinnati College of Engineering Sciences Cincinnati OH USA
| | - Angela Ellard
- University of Cincinnati College of Nursing Cincinnati OH USA
| | - John Greer Clark
- University of Cincinnati College of Allied Health Sciences Cincinnati OH USA
| | | | - Dieter Vanderelst
- University of Cincinnati College of Arts and Sciences, and University of Cincinnati College of Engineering Sciences Cincinnati OH USA
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Hopgood DA, Czosek RJ, Bakas T, Garritano N, Gillespie GL. The Capture Gap: Implantable Cardioverter-Defibrillator Quality of Life. Clin Nurs Res 2018; 29:97-107. [PMID: 30295057 DOI: 10.1177/1054773818803741] [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] [Indexed: 11/16/2022]
Abstract
We aimed to compare salient characteristics and antecedents of quality of life (QOL) in adolescents and young adults with implantable cardioverter-defibrillators (ICDs) from qualitative methods with quantitative measurement of QOL and correlations between QOL (PedsQL) and measured participant characteristics. Concurrent parallel mixed methods design was used to collect survey data from the PedsQL electronic health record, demographic questionnaire, and semistructured interview data. A convenience sample of 16 individuals with ICDs, aged 13 to 25 years, was obtained from a tertiary pediatric facility. Overall QOL and subdomains of physical, psychosocial, and academic/work were examined by PedsQL and visual analog scale. Select demographics were collected to develop a participant profile. Females with ICDs appear to be at risk of poor QOL given some unknown factors. Financial status of the individual and the family was positively related to QOL. For new ICD persons involved in physical activities that must be stopped, peer support appears to improve QOL.
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Affiliation(s)
- Daniel A Hopgood
- University of Cincinnati, OH, USA.,Ohio University, Athens, OH, USA
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McCarthy MJ, Bakas T, Schellinger J, Stapleton K, Kissela BM. Association between incongruence about survivor function and outcomes among stroke survivors and family caregivers. Top Stroke Rehabil 2018; 25:569-575. [PMID: 30207873 DOI: 10.1080/10749357.2018.1503458] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Stroke survivors and family caregivers often have incongruent appraisals of survivor cognitive, physical, and psychosocial function. Partner incongruence contributes to poor outcomes for survivors and caregivers. OBJECTIVES This study explored whether partner incongruence: (1) differs by function domain; (2) increases or decreases over time, and; (3) is associated with self-rated health, distress, stress, and depressive symptoms. METHODS Structured surveys were administered to 32 survivors and caregivers at approximately 3 (enrollment) and 7 months (follow-up) post-stroke. Paired t-tests were used to examine partners' ratings of survivor function at enrollment and follow-up, and changes in incongruence over time. Partial correlations were used to examine the association between incongruence at enrollment and outcomes at follow-up. RESULTS Survivors consistently rated their own memory and thinking as significantly better than caregivers rated their memory and thinking. At follow-up, survivors rated their own communication as significantly better than caregivers rated their communication. Incongruence about survivor memory and thinking was associated with survivor distress, as well as caregiver distress, stress, and depressive symptoms. Incongruence about survivor ADLs was associated with caregiver stress and depressive symptoms. Incongruence about survivor social participation was associated with caregiver distress. CONCLUSIONS Findings from this study suggest that survivors and caregivers often have incongruent appraisals of survivor function, that incongruence does not improve naturally over time, and that incongruence may be detrimental for survivor and caregiver outcomes. Further research should be directed at the mitigation of incongruence and strategies to improve outcomes for both survivors and family caregivers.
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Affiliation(s)
- Michael J McCarthy
- a School of Social Work, College of Allied Health Sciences , University of Cincinnati , Cincinnati , OH , USA
| | - Tamilyn Bakas
- b College of Nursing , University of Cincinnati , Cincinnati , OH , USA
| | - Jeffrey Schellinger
- a School of Social Work, College of Allied Health Sciences , University of Cincinnati , Cincinnati , OH , USA
| | - Katie Stapleton
- a School of Social Work, College of Allied Health Sciences , University of Cincinnati , Cincinnati , OH , USA
| | - Brett M Kissela
- c College of Medicine, University of Cincinnati , Cincinnati , OH , USA
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Bakas T, Sampsel D, Israel J, Chamnikar A, Bodnarik B, Clark JG, Ulrich MG, Vanderelst D. Using telehealth to optimize healthy independent living for older adults: A feasibility study. Geriatr Nurs 2018; 39:566-573. [PMID: 29804689 DOI: 10.1016/j.gerinurse.2018.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/30/2018] [Accepted: 04/02/2018] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to test feasibility of the Telehealth Community Health Assistance Team (T-CHAT), a nurse-led intervention delivered through a telepresence robot designed to promote healthy independent living among older adults. Using a quasi-experimental design, 21 older adults were divided into a T-CHAT group (n = 11) or a waitlist control group (n = 10). The T-CHAT group received 3 weekly health coaching sessions from a nurse practitioner student through the telepresence robot. Data trends were analyzed using two-way repeated measures analysis of covariance (ANCOVA) with baseline values as co-variates; effect sizes using partial eta squared (η2). Medium to large improvements in unhealthy days, depressive symptoms, sleep, quality of life, and confidence/self-efficacy were found favoring the T-CHAT group. Recruitment and retention strategies were successful, with lessons learned for future studies. Further research is warranted to refine and test efficacy of the T-CHAT program to promote healthy independent living among older adults.
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Affiliation(s)
- Tamilyn Bakas
- University of Cincinnati College of Nursing, PO Box 210038, Cincinnati, OH 45219, USA.
| | - Debi Sampsel
- University of Cincinnati College of Nursing, PO Box 210038, Cincinnati, OH 45219, USA
| | - Jahmeel Israel
- University of Cincinnati College of Nursing, PO Box 210038, Cincinnati, OH 45219, USA
| | - Ameya Chamnikar
- University of Cincinnati College of Engineering and Applied Sciences, PO Box 210072, Cincinnati, OH 45219, USA
| | - Barbara Bodnarik
- University of Cincinnati College of Nursing, PO Box 210038, Cincinnati, OH 45219, USA
| | - John Greer Clark
- University of Cincinnati College of Allied Health Sciences, PO Box 210394, Cincinnati, OH 45219, USA
| | | | - Dieter Vanderelst
- University of Cincinnati College of Engineering and Applied Sciences, PO Box 210072, Cincinnati, OH 45219, USA; University of Cincinnati College of Arts and Sciences, Edwards 1 45150Q, Cincinnati, OH 45221, USA
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Kreitzer N, Kurowski BG, Bakas T. Systematic Review of Caregiver and Dyad Interventions After Adult Traumatic Brain Injury. Arch Phys Med Rehabil 2018; 99:2342-2354. [PMID: 29752909 DOI: 10.1016/j.apmr.2018.04.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 01/11/2018] [Revised: 03/13/2018] [Accepted: 04/14/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To describe and synthesize the literature on adult traumatic brain injury (TBI) family caregiver and dyad intervention. TBI is a common injury that has a significant long-term impact, and is sometimes even characterized as a chronic condition. Informal (ie, unpaid) family caregivers of adults with TBI experience high rates of burnout, depression, fatigue, anxiety, lower subjective well-being, and poorer levels of physical health compared to noncaregivers. This study addresses the critical gap in the understanding of interventions designed to address the impact of TBI on adult patients and their family caregivers. DATA SOURCES PubMed and MEDLINE. STUDY SELECTION Studies selected for review had to be written in English and be quasi-experimental or experimental in design, report on TBI caregivers, survivors with heavy involvement of caregivers, or caregiver dyads, involve moderate and severe TBI, and describe an intervention implemented during some portion of the TBI care continuum. DATA EXTRACTION The search identified 2171 articles, of which 14 met our criteria for inclusion. Of the identified studies, 10 were randomized clinical trials and 4 were nonrandomized quasi-experimental studies. A secondary search to describe studies that included individuals with other forms of acquired brain injury in addition to TBI resulted in 852 additional titles, of which 5 met our inclusion criteria. DATA SYNTHESIS Interventions that targeted the caregiver primarily were more likely to provide benefit than those that targeted caregiver/survivor dyad or the survivor only. Many of the studies were limited by poor fidelity, low sample sizes, and high risk for bias based on randomization techniques. CONCLUSIONS Future studies of TBI caregivers should enroll a more generalizable number of participants and ensure adequate fidelity to properly compare interventions.
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Affiliation(s)
- Natalie Kreitzer
- Department of Emergency Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, United States; Division of Neurocritical Care, College of Medicine, University of Cincinnati, Cincinnati, Ohio, United States.
| | - Brad G Kurowski
- Department of Pediatrics, Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio, United States
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, United States
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50
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Dunbar SB, Khavjou OA, Bakas T, Hunt G, Kirch RA, Leib AR, Morrison RS, Poehler DC, Roger VL, Whitsel LP. Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association. Circulation 2018; 137:e558-e577. [DOI: 10.1161/cir.0000000000000570] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Introduction:
In a recent report, the American Heart Association estimated that medical costs and productivity losses of cardiovascular disease (CVD) are expected to grow from $555 billion in 2015 to $1.1 trillion in 2035. Although the burden is significant, the estimate does not include the costs of family, informal, or unpaid caregiving provided to patients with CVD. In this analysis, we estimated projections of costs of informal caregiving attributable to CVD for 2015 to 2035.
Methods:
We used data from the 2014 Health and Retirement Survey to estimate hours of informal caregiving for individuals with CVD by age/sex/race using a zero-inflated binomial model and controlling for sociodemographic factors and health conditions. Costs of informal caregiving were estimated separately for hypertension, coronary heart disease, heart failure, stroke, and other heart disease. We analyzed data from a nationally representative sample of 16 731 noninstitutionalized adults ≥54 years of age. The value of caregiving hours was monetized by the use of home health aide workers’ wages. The per-person costs were multiplied by census population counts to estimate nation-level costs and to be consistent with other American Heart Association analyses of burden of CVD, and the costs were projected from 2015 through 2035, assuming that within each age/sex/racial group, CVD prevalence and caregiving hours remain constant.
Results:
The costs of informal caregiving for patients with CVD were estimated to be $61 billion in 2015 and are projected to increase to $128 billion in 2035. Costs of informal caregiving of patients with stroke constitute more than half of the total costs of CVD informal caregiving ($31 billion in 2015 and $66 billion in 2035). By age, costs are the highest among those 65 to 79 years of age in 2015 but are expected to be surpassed by costs among those ≥80 years of age by 2035. Costs of informal caregiving for patients with CVD represent an additional 11% of medical and productivity costs attributable to CVD.
Conclusions:
The burden of informal caregiving for patients with CVD is significant; accounting for these costs increases total CVD costs to $616 billion in 2015 and $1.2 trillion in 2035. These estimates have important research and policy implications, and they may be used to guide policy development to reduce the burden of CVD on patients and their caregivers.
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