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Modde Epstein C, Rice MJ, French JA, Kupzyk KA, Houfek JF. Social Support Buffers the Effects of Prenatal Depressed Mood: A Mixed-Methods Study. J Am Psychiatr Nurses Assoc 2024; 30:95-107. [PMID: 35081823 DOI: 10.1177/10783903211073793] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Women use various coping strategies to deal with stress and depression. These strategies are shaped by social contexts over the life course and may attenuate and/or exacerbate the physiologic effects of depression. AIMS: The purpose of this study was to determine whether coping strategies (active, disengaged, or social support coping) moderate depression-related diurnal cortisol dysregulation and to explore how social context influences women's use of coping. METHODS: This was a mixed-methods study of pregnant women (N = 65) during mid-pregnancy. Cortisol was measured in saliva collected during the waking hours of the day. Participants completed the Edinburgh Depression Scale and the Brief COPE. A subset of the sample participated in semistructured qualitative interviews (n = 20). RESULTS: Social support coping, but not active or disengaged coping, moderated end-of-day cortisol levels. Among depressed women, higher use of social support was associated with lower and more dynamic (i.e., less flat) diurnal cortisol rhythms. The qualitative findings revealed how complex social dynamics related to financial insecurity, lack of mutuality, and social identity affected women's use of and access to social support. CONCLUSION: These findings support theories of the stress-buffering effects of social support. Future research is needed to examine how social determinants affect access to social support, and how early life social experiences condition women's adaptive formation of social support coping strategies over the life course. Clinically, these findings underscore the value of relationship-centered nursing care for depressed women.
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Affiliation(s)
- Crystal Modde Epstein
- Crystal Modde Epstein, PhD, RN, PMHNP-BC, University of Nebraska Medical Center, Omaha, NE, USA; University of North Carolina Greensboro, NC, USA
| | - Michael J Rice
- Michael J. Rice, PhD, APRN-NP, FAAN, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jeffrey A French
- Jeffrey A. French, PhD, University of Nebraska at Omaha, NE, USA
| | - Kevin A Kupzyk
- Kevin A. Kupzyk, PhD, University of Nebraska Medical Center, Omaha, NE, USA
| | - Julia F Houfek
- Julia F. Houfek, PhD, APRN-CNS, University of Nebraska Medical Center, Omaha, NE, USA
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2
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Darby M, Petersen MC, Stoltman A, Kupzyk KA. Storytelling as an Education Strategy for Undergraduate Nursing Students. Nurse Educ 2023; 48:E176-E177. [PMID: 37058412 DOI: 10.1097/nne.0000000000001397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Affiliation(s)
- Mark Darby
- Clinical Instructor (Mr Darby and Ms Petersen), Administrator II, Transformational Practice and Partnerships (Ms Stoltman), and Assistant Professor (Dr Kupzyk), University of Nebraska Medical Center College of Nursing, 985330 Nebraska Medical Center, Omaha
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Cook LK, Burge SA, Mathews TL, Kupzyk KA, Houfek JF. Implementing an APRN-Led Integrated Behavioral Health Clinic in a Rural Community. J Am Psychiatr Nurses Assoc 2023:10783903231185783. [PMID: 37421155 DOI: 10.1177/10783903231185783] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
OBJECTIVE A rural primary care clinic implemented an advance practice providers, including nurse practitioner (APRN)-led integrated behavioral health program to facilitate holistic health care delivery. METHODS Implementation was facilitated by Health Resources and Services Administration Grant funding to a state University College of Nursing. The College formed an academic-practice partnership with a Federally Qualified Health Center (FQHC) to implement integrated care in a rural satellite clinic administered by the FQHC. An interdisciplinary team (two family APRNs, a psychiatric APRN, a licensed behavioral health provider, and the Grant Project Director who is a Psychiatric APRN and a licensed Psychologist) provided the integrated care based on the University of Washington's Collaborative Care Model. RESULTS This brief report describes the implementation of integrated care during the clinic's first year, services provided, lessons learned, community response, and improvement in anxiety and depressive symptoms for patients who were treated for behavioral health problems. An exemplar illustrates how collaborative care addressed one patient's behavioral health and primary care needs. CONCLUSIONS APRN-led collaborative care can expand access to holistic, affordable care in rural areas to improve mental health. Adaptation and flexibility in traditional roles may be necessary and determining post-grant access to funding for services will be necessary for sustainability.
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Affiliation(s)
- Leigh K Cook
- Leigh K. Cook, MSN, APRN-NP, FNP-C, PMHNP-BC, UNMC College of Nursing, Omaha, NE, USA
| | - Stephanie A Burge
- Stephanie A. Burge, DNP, FNP-BC, UNMC College of Nursing, Kearney, NE, USA
| | - Therese L Mathews
- Therese L. Mathews, PhD, PPCNP-BC, PMHNP-BC, UNMC College of Nursing, Omaha, NE, USA
| | - Kevin A Kupzyk
- Kevin A. Kupzyk, PhD, UNMC College of Nursing, Omaha, NE, USA
| | - Julia F Houfek
- Julia F. Houfek, PhD, APRN-CNS, UNMC College of Nursing, Omaha, NE, USA
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4
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Hulme PA, Wegehaupt M, Kupzyk KA, French JA. An approach for studying the contributions of childhood sexual abuse and HPA axis dysregulation to substance use disorders. Arch Psychiatr Nurs 2023; 42:9-17. [PMID: 36842834 DOI: 10.1016/j.apnu.2022.12.003] [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: 09/01/2021] [Revised: 09/25/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
An environmental risk factor for substance abuse and dependence is childhood sexual abuse (CSA). We piloted an approach we developed to test the hypothesis that hypothalamic-pituitary-adrenal (HPA) axis dysregulation from the stress of CSA is a biological mediator. We based our hypothesis on the allostasis model. New admissions to residential treatment for substance use disorders (N = 41) were evaluated for CSA history and two HPA axis regulation measures at baseline, one month, and two months. The two HPA axis regulation measures were morning cortisol level and the dexamethasone suppression test. Five potential covariates were also measured to increase reliability of the findings. Feasibility outcomes were mostly favorable, and included rates of participation (57 %), attrition (46 % at one month and 71 % at two months), and compliance with data collection procedures (87 % for morning cortisol level and 84 % for the dexamethasone suppression test). High attrition rates at one and two months were entirely attributable to high rates of leaving treatment, an important consideration for future studies. Baseline correlations among variables showed a significant negative correlation between dexamethasone suppression and perceived stress, a potential covariate (rho = -0.458). This finding suggests that individuals with lower stress levels have better negative feedback regulation of the HPA axis, which results in the benefit of lower cortisol exposure-a finding congruent with the allostasis model.
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Affiliation(s)
- Polly A Hulme
- College of Nursing, South Dakota State University, 1060 Campanile Ave, Brookings, SD 57007, United States of America.
| | | | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, 4111 Dewey Ave., Omaha, NE 68198-5330, United States of America.
| | - Jeffrey A French
- Department of Psychology, University of Nebraska at Omaha, 6001 Dodge Street, Omaha, NE 68182, United States of America.
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Alonso WW, Kupzyk KA, Norman JF, Lundgren SW, Fisher A, Lindsey ML, Keteyian SJ, Pozehl BJ. The HEART Camp Exercise Intervention Improves Exercise Adherence, Physical Function, and Patient-Reported Outcomes in Adults With Preserved Ejection Fraction Heart Failure. J Card Fail 2022; 28:431-442. [PMID: 34534664 PMCID: PMC8920955 DOI: 10.1016/j.cardfail.2021.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite exercise being one of few strategies to improve outcomes for individuals with heart failure with preserved ejection fraction (HFpEF), exercise clinical trials in HFpEF are plagued by poor interventional adherence. Over the last 2 decades, our research team has developed, tested, and refined Heart failure Exercise And Resistance Training (HEART) Camp, a multicomponent behavioral intervention to promote adherence to exercise in HF. We evaluated the effects of this intervention designed to promote adherence to exercise in HF focusing on subgroups of participants with HFpEF and heart failure with reduced ejection fraction (HFrEF). METHODS AND RESULTS This randomized controlled trial included 204 adults with stable, chronic HF. Of those enrolled, 59 had HFpEF and 145 had HFrEF. We tested adherence to exercise (defined as ≥120 minutes of moderate-intensity [40%-80% of heart rate reserve] exercise per week validated with a heart rate monitor) at 6, 12, and 18 months. We also tested intervention effects on symptoms (Patient-Reported Outcomes Measurement Information System-29 and dyspnea-fatigue index), HF-related health status (Kansas City Cardiomyopathy Questionnaire), and physical function (6-minute walk test). Participants with HFpEF (n = 59) were a mean of 64.6 ± 9.3 years old, 54% male, and 46% non-White with a mean ejection fraction of 55 ± 6%. Participants with HFpEF in the HEART Camp intervention group had significantly greater adherence compared with enhanced usual care at both 12 (43% vs 14%, phi = 0.32, medium effect) and 18 months (56% vs 0%, phi = 0.67, large effect). HEART Camp significantly improved walking distance on the 6-minute walk test (η2 = 0.13, large effect) and the Kansas City Cardiomyopathy Questionnaire overall (η2 = 0.09, medium effect), clinical summary (η2 = 0.16, large effect), and total symptom (η2 = 0.14, large effect) scores. In the HFrEF subgroup, only patient-reported anxiety improved significantly in the intervention group. CONCLUSIONS A multicomponent, behavioral intervention is associated with improvements in long-term adherence to exercise, physical function, and patient-reported outcomes in adults with HFpEF and anxiety in HFrEF. Our results provide a strong rationale for a large HFpEF clinical trial to validate these findings and examine interventional mechanisms and delivery modes that may further promote adherence and improve clinical outcomes in this population. CLINICAL TRIAL REGISTRATION URL: https://clinicaltrials.gov/. Unique identifier: NCT01658670.
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Affiliation(s)
- Windy W. Alonso
- College of Nursing,University of Nebraska Medical Center, Omaha, NE 68198,Corresponding author: Windy W. Alonso, PhD, RN, FHFSA, University of Nebraska Medical Center-College of Nursing, 985330 Nebraska Medicine, Omaha, NE 68198-5330, , Phone number: 402-559-8342, Fax number: 402-559-9666
| | - Kevin A. Kupzyk
- College of Nursing,University of Nebraska Medical Center, Omaha, NE 68198
| | - Joseph F. Norman
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198
| | - Scott W. Lundgren
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68918
| | - Alfred Fisher
- Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198
| | - Merry L. Lindsey
- Department of Cellular and Integrative Physiology, Center for Heart and Vascular Research, University of Nebraska Medical Center, Omaha, NE 68102,Research Service, Nebraska-Western Iowa Health Care System, Omaha, NE 68198
| | | | - Bunny J. Pozehl
- College of Nursing,University of Nebraska Medical Center, Omaha, NE 68198
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6
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Woods MJ, Lundgren SW, Poon CYM, Kupzyk KA, Alonso WW. Pre-left Ventricular Assist Device Cognition: A Comparison of Rural and Urban Implant Recipients. ASAIO J 2022; 68:369-373. [PMID: 35213885 DOI: 10.1097/mat.0000000000001491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Mild cognitive impairment (MCI) is common in patients before left ventricular assist device (LVAD) placement. The consequences of these deficits may differentially impact groups of patients with limited access to postimplantation resources, such as those in rural areas. However, to date, no studies have examined preimplantation cognition in rural and urban patients. Therefore, the purpose of this study was to compare cognition in rural and urban patients before LVAD implantation. This observational cohort study is a secondary analysis of 265 patients undergoing LVAD implantation between July 2004 and June 2019. Preimplantation cognitive function was assessed. Rural-Urban Commuting Area Codes designated rural and urban. Independent-samples Mann-Whitney U tests were used to compare rural and urban cohorts. Subjects were 75.8% (201/265) male, 75.4% (200/265) urban, and 56.6% (±13.2) years old. Rural subjects scored significantly lower on the Mini Mental Status Exam (MMSE) (27 ± 2.20) and Wide Range Achievement Test (WRAT) (32 ± 22.9) compared with urban counterparts (MMSE, 27.6 ± 2.7) (p = 0.009); WRAT (44.4 ± 26.2) (p = 0.02) pre-LVAD. These findings suggest rural patients may have greater MCI before LVAD implantation. Rural LVAD recipients with MCI may require additional intensive education and tailored resource identification before discharge.
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Affiliation(s)
- Mallory J Woods
- From the College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska
| | - Scott W Lundgren
- Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska
| | | | - Kevin A Kupzyk
- From the College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska
| | - Windy W Alonso
- From the College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska
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7
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Waltman N, Kupzyk KA, Flores LE, Mack LR, Lappe JM, Bilek LD. Bone-loading exercises versus risedronate for the prevention of osteoporosis in postmenopausal women with low bone mass: a randomized controlled trial. Osteoporos Int 2022; 33:475-486. [PMID: 34519832 DOI: 10.1007/s00198-021-06083-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/24/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This randomized controlled trial compared changes in bone mineral density (BMD) and bone turnover in postmenopausal women with low bone mass randomized to 12 months of either risedronate, exercise, or a control group. METHODS Two hundred seventy-six women with low bone mass, within 6 years of menopause, were included in analysis. Treatment groups were 12 months of (a) calcium and vitamin D supplements (CaD) (control), (b) risedronate + CaD (risedronate), or (c) bone-loading exercises + CaD (exercise). BMD and serum markers for bone formation (Alkphase B) and resorption (Serum Ntx) were analyzed at baseline, 6, and 12 months. RESULTS Using hierarchical linear modeling, a group by time interaction was found for BMD at the spine, indicating a greater improvement in the risedronate group compared to exercise (p ≤ .010) or control groups (p ≤ .001). At 12 months, for women prescribed risedronate, changes in BMD at the spine, hip, and femoral neck from baseline were + 1.9%, + 0.9%, and + .09%; in exercise group women, + 0.2%, + 0.5%, and - 0.4%; and in control group women, - 0.7%, + 0.5%, and - 0.5%. There were also significant differences in reductions in Alkphase B (RvsE, p < .001, RvsC, p < .001) and Serum Ntx (RvsE, p = .004, RvsC, p = .007) in risedronate women compared to exercise and control groups. For risedronate, 12-month changes in Alkphase B and Serum Ntx were - 20.3% and - 19.0%; for exercise, - 6.7% and - 7.0%; and for control, - 6.3% and - 9.0%. CONCLUSION Postmenopausal women with low bone mass should obtain adequate calcium and vitamin D and participate in bone-loading exercises. Additional use of BPs will increase BMD, especially at the spine.
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Affiliation(s)
- Nancy Waltman
- College of Nursing, University of Nebraska Medical Center, 550 N 19th, Street, Suite 350E, Lincoln, NE, 6850-0620, USA.
| | - Kevin A Kupzyk
- Center for Nursing Science, University of Nebraska Medical Center, 4101 Dewey Avenue, Omaha, NE, 68198-5330, USA
| | - Laura E Flores
- College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
| | - Lynn R Mack
- Diabetes, Endocrinology, & Metabolism, Nebraska Medicine, Omaha, NE, 68198-4130, USA
| | - Joan M Lappe
- Creighton Osteoporosis Research Center, 601 North 30th, Omaha, NE, 68131, USA
| | - Laura D Bilek
- College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
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8
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Hetland BD, McAndrew NS, Kupzyk KA, Krutsinger DC, Pozehl BJ, Heusinkvelt JM, Camenzind CE. Family Caregiver Preferences and Contributions Related to Patient Care in the ICU. West J Nurs Res 2021; 44:214-226. [PMID: 34904483 DOI: 10.1177/01939459211062954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Guided by Individual and Family Self-Management Theory, the purpose of this cross-sectional study was to describe patient care activities that family caregivers endorsed and performed while visiting their family member in the ICU. We found that caregivers wanted to be involved in ICU patient care and had preferences for the care they wanted to perform with their critically ill family member. More than 80% preferred to perform tasks related to daily grooming, communication, and education. Of note, many caregivers expressed interest in holistic healing activities (i.e., music and art), and yet, less than 50% of caregivers reported participating in these activities. The discrepancy between the number of care activities that respondents desired to perform compared to the number of care activities they reported performing represents an important opportunity to shift research and practice improvement efforts toward more tailored family engagement interventions and recognition of family caregivers as essential partners in care.
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Affiliation(s)
- Breanna D Hetland
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA.,Critical Care Division, Nebraska Medicine, Omaha, NE, USA
| | - Natalie S McAndrew
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.,Froedtert Hospital, Froedtert & Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Dustin C Krutsinger
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Bunny J Pozehl
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
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9
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Stamler LL, Hanna KM, Kupzyk KA, DeSouza C. Testing the Psychometric Characteristics of the Revised Mastery of Stress Instrument in Adults With Type 2 Diabetes. J Nurs Meas 2021; 30:518-529. [PMID: 34518394 DOI: 10.1891/jnm-d-20-00137] [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: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE A promising, yet lengthy measure to identify mastery of patient-identified stress is Younger's (1991, 1993) Mastery of Stress Instrument (MSI). With a goal for a parsimonious and valid measure, this study determined the psychometric properties of a reduced item instrument with adults diagnosed with type 2 diabetes. METHODS First, an expert content analysis was completed. Second, item and confirmatory factor analysis were completed with a sample of 200 adults with a diagnosis of type 2 diabetes. RESULTS Eight items were removed through content validity and seven items were removed with Item analysis. Factor analysis supported Younger's four sub-concepts. CONCLUSIONS Future research with this revised MSI scale is advocated to identify those who may need strategies to increase their mastery of stress.
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10
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Herstein JJ, Gibbs SG, Kupzyk KA, Beam EL. Using a Critical Safety Behavior Scoring Tool for Just-in-Time Training for N95 Respirator Use. Workplace Health Saf 2021; 70:31-36. [PMID: 34425725 DOI: 10.1177/21650799211031169] [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
BACKGROUND Historically, health care workers (HCWs) have exhibited marginal adherence to proper N95 respirator use. During the COVID-19 pandemic, HCWs with little to no prior training on N95 respirator use are relying on N95s as their primary respiratory protection. There is a need for simple, effective, and easily implementable just-in-time training (JITT) interventions to improve N95 respirator-related safety behavior. This study investigated two JITT interventions. METHODS A pilot experimental pretest posttest study design was used to evaluate two training interventions for N95 respirator donning/doffing performance at a Midwestern hospital system. HCW participants were randomly assigned to an intervention: one used a 4-minute instructional video alone, while the other used the same video but added a video reflection intervention (participant watched and scored a video of their own performance). All performances were scored using a 10-point Critical Safety Behavior Scoring Tool (CSBST). FINDINGS Sixty-two HCWs participated (32 video alone, 30 video reflection). The two groups' CSBST scores were not significantly different at pretest. Averaged participant scores on the CSBST improved immediately following both interventions. Scores were significantly higher on the posttest for the reflective practice intervention (p<.05). Years of experience and frequency of N95 respirator use did not predict pre or post scores. CONCLUSIONS/APPLICATIONS TO PRACTICE We provide evidence to support the use of a time-efficient JITT intervention to improve HCW N95 respirator donning/doffing practices during the COVID-19 pandemic and beyond. Hospital safety professionals should consider this type of training for HCWs required to wear respiratory protection.
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11
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Dickinson K, Lim A, Kupzyk KA. Demographic, Symptom, and Lifestyle Factors Associated With Cancer-Related Fatigue in Men With Prostate Cancer. Oncol Nurs Forum 2021; 48:423-430. [PMID: 34142995 DOI: 10.1188/21.onf.423-430] [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: 11/17/2022]
Abstract
OBJECTIVES To identify potential demographic, symptom, and lifestyle factors associated with cancer-related fatigue (CRF) in men with prostate cancer. SAMPLE & SETTING Data were retrieved from men with prostate cancer across the disease trajectory who were enrolled in the Genitourinary Cancer Collaborative Registry-Prostate Cancer. METHODS & VARIABLES Self-reported data on demographic characteristics, lifestyle habits (smoking history, alcohol consumption, physical activity/exercise, dietary habits, and vitamins/supplements), and symptom experiences (measured using the Brief Fatigue Inventory, European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Prostate Cancer and -Bone Metastasis, and Pittsburgh Sleep Quality Index) were included in the registry. RESULTS Demographic (younger age) and symptom (sleep quality, urinary, bowel, hormone-related, and sexual activity) correlates of CRF were identified. Higher levels of moderate to vigorous exercise and activities were associated with lower CRF in the sample as a whole. However, there was no association between CRF and physical activity in men with bone metastasis. IMPLICATIONS FOR NURSING CRF is a common and burdensome symptom among individuals with cancer and survivors. Identification of demographic, symptom, and lifestyle factors associated with CRF can enhance understanding of this symptom and contribute to early risk assessment and intervention.
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12
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Hanna KM, Kupzyk KA, Hansen JR, Jones-Ryan ML, Drincic AT. Association of habits, triggers, glycaemic control, routines, stress and impulse control among emerging adults with type 1 diabetes. Diabet Med 2021; 38:e14370. [PMID: 32745273 DOI: 10.1111/dme.14370] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/19/2020] [Accepted: 07/27/2020] [Indexed: 11/27/2022]
Abstract
AIM Glycaemic control is known to be poor among emerging adults with type 1 diabetes, but the reasons for this are poorly understood. Examination of diabetes self-management-related habits, triggers and daily routines within the context of impulse control and perceived daily stress may provide increased understanding of glycaemic control during this transitional period. This study examined associations among checking blood glucose (CBG) habits, eating a meal (EAM) habits and glycaemic control within the context of CBG triggers, daily routines, impulse control and perceived daily stress, in emerging adults with type 1 diabetes. METHODS A cross-sectional convenience sample of 100 emerging adults with type 1 diabetes was recruited from an outpatient diabetes care clinic for this age group. Participants self-reported frequency of CBG and EAM habits, CBG triggers, daily routines, perceived daily stress and impulse control. Glycaemic control values were obtained from medical records. Path analysis was performed. RESULTS Better glycaemic control was positively and significantly associated with greater frequency of CBG and EAM habits. CBG habits were positively and significantly associated with CBG triggers and EAM habits. EAM habits were positively and significantly associated with daily routines. CONCLUSIONS We suggest interventional research targeting CBG and EAM habits and daily routines to examine the impact on diabetes self-management and glycaemic control.
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Affiliation(s)
- K M Hanna
- University of Nebraska Medical Center, College of Nursing, Omaha, NE, USA
| | - K A Kupzyk
- University of Nebraska Medical Center, College of Nursing, Omaha, NE, USA
| | - J R Hansen
- University of Nebraska Medical Center, College of Nursing, Omaha, NE, USA
| | - M L Jones-Ryan
- University of Nebraska Medical Center, College of Medicine, Omaha, NE, USA
| | - A T Drincic
- University of Nebraska Medical Center, College of Medicine, Omaha, NE, USA
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13
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Waltman N, Cole MA, Kupzyk KA, Lappe JM, Mack LR, Bilek LD. Promoting adherence to bone-loading exercises in postmenopausal women with low bone mass. J Am Assoc Nurse Pract 2021; 34:50-61. [PMID: 33560754 DOI: 10.1097/jxx.0000000000000564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/19/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND We recently completed a parent study (Bone Loading Exercises versus Risedronate on Bone Health in Post-menopausal Women [NIH# R01NR015029]) examining bone-loading exercises to prevent bone loss in postmenopausal women with low bone mass. Forty-three million US women have low bone mass and increased risk for fractures. Bone-loading exercises (weight-bearing and resistance training) can preserve bone mass and decrease risk of fractures. However, multiple barriers prevent women from exercising and adherence rates are low. PURPOSE This secondary analysis of the parent study (a) examined barriers specific to women participating in bone-loading exercises; (b) described effectiveness of self-efficacy strategies used in the parent study for increasing confidence in knowledge and reducing barriers; and (c) applied study findings and principles of self-efficacy and self-regulation in development of guidelines for promoting adherence to exercises. METHODS Seventy-two women were randomized to the exercise group and completed 12 months of exercises. Instruments for self-efficacy were completed at 2 weeks and barriers interference at 6 months. Percent adherence was measured as the number of exercise sessions attended divided by the number prescribed. RESULTS In the 12-month study, average adherence to exercises was 58.9%. Lower adherers reported lack of self-regulation skills such as "lack of time" as the most frequent barriers to exercise. IMPLICATIONS FOR PRACTICE Guidelines developed included promotion of skills for self-regulation (such as regulation of time) as well as self-efficacy to improve adherence rates. Nurse practitioners may be the most motivated of all providers to use guidelines promoting exercise for women in their clinical practice.
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Affiliation(s)
- Nancy Waltman
- College of Nursing, University of Nebraska Medical Center, College of Nursing, Lincoln, Nebraska
| | - Melissa A Cole
- Research Study Project, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska
| | - Kevin A Kupzyk
- Center for Nursing Science, University of Nebraska Medical Center, Omaha, Nebraska
| | - Joan M Lappe
- Creighton Osteoporosis Research Center, Creighton University, Omaha, Nebraska
| | - Lynn R Mack
- Department of Diabetes, Endocrinology & Metabolism, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Laura D Bilek
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska
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Beam EL, Herstein JJ, Kupzyk KA, Gibbs SG. A simulation approach to measure critical safety behaviors when evaluating training methods for respirator education in healthcare workers. Am J Infect Control 2020; 48:869-874. [PMID: 32407827 PMCID: PMC7214345 DOI: 10.1016/j.ajic.2020.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/05/2020] [Accepted: 05/05/2020] [Indexed: 12/01/2022]
Abstract
N95 respirators are a common tool in healthcare for airborne isolation and pandemic response. Simulation can be used to train healthcare workers. Reflective practice may be a training intervention to improve N95 respirator use compared to video alone.
Background The N95 respirator is the most common safety tool used in hospitals to protect health care workers (HCW) from inhaling airborne particles. Focusing on HCW behavior related to respirator use is an effective route to improve HCW safety and respiratory health. Methods Participants were asked to perform the donning and doffing of an N95 respirator to camera. Then they were randomized to a video alone or a reflective practice intervention. After the intervention they repeated the donning and doffing to camera. A critical safety behavior scoring tool (CSBST) was developed to compare the performance of the participants over time at pretest, post-test and 1 month later for follow-up. Results The reflective practice intervention group was found to have significantly higher scores on the CSBST at post-test and follow-up than the video alone group. In the reflective practice intervention group, the participants perceived they were better at performing the N95 donning and doffing than the experts scored them. Conclusions The CSBST is a tool to measure the performance of HCWs on a specific targeted safety behaviors. The addition of a reflective practice intervention may result in a measurable and sustained improvement in the safety behaviors demonstrated when using the N95 respirator.
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15
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Epstein CM, Houfek JF, Rice MJ, Weiss SJ, French JA, Kupzyk KA, Hammer SJ, Pullen CH. Early life adversity and depressive symptoms predict cortisol in pregnancy. Arch Womens Ment Health 2020; 23:379-389. [PMID: 31289940 PMCID: PMC7913604 DOI: 10.1007/s00737-019-00983-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 10/29/2018] [Accepted: 06/07/2019] [Indexed: 11/28/2022]
Abstract
Evidence suggests that exposure to early life adversity (ELA) programs the hypothalamic-pituitary-adrenal (HPA) axis to influence responses to later adversity and predisposes women to depression. However, few studies have examined whether ELA moderates the HPA cortisol response to adulthood adversity and depressive symptoms in pregnant women. The aims of this study were to determine (a) whether ELA, adulthood adversity, and depressive symptoms differentially predict patterns of cortisol and (b) whether ELA moderates the relationship of adulthood adversity or depressive symptoms to cortisol. This was a descriptive, cross-sectional study of pregnant women (N = 58, mean = 26.5 weeks gestation). Participants completed the Stress and Adversity Inventory and Edinburgh Depression Scale and collected salivary cortisol five times per day for 3 days to assess cortisol awakening response (CAR), diurnal cortisol slope, and cortisol area under the curve (AUC). ELA predicted a larger CAR, while depressive symptoms predicted a blunted CAR and higher cortisol AUC. Adulthood adversity predicted a blunted CAR and steeper diurnal slope, but only in women with high ELA. ELA also moderated the effect of depressive symptoms on diurnal slope. Early adversity and depressive symptoms appear to have significant effects on the HPA axis during pregnancy, with early adversity also moderating effects of depressive symptoms and adulthood adversity on cortisol regulation. Early adversity may be an important factor in identifying unique HPA phenotypes and risk for HPA axis dysregulation in pregnancy.
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Affiliation(s)
- Crystal Modde Epstein
- UCSF School of Nursing, 2 Koret Way, San Francisco, CA, 94143, USA. .,UNMC College of Nursing, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA.
| | - Julia F Houfek
- UNMC College of Nursing, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA
| | - Michael J Rice
- College of Nursing, University of Colorado Anschutz Medical Campus, 13120 East 19th Ave, Ed 2 North Bldg, Aurora, CO, 80045, USA
| | - Sandra J Weiss
- UCSF School of Nursing, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Jeffrey A French
- Department of Psychology, University of Nebraska at Omaha, 6001 Dodge St Allwine Hall 419, Omaha, NE, 68182, USA
| | - Kevin A Kupzyk
- UNMC College of Nursing, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA
| | - Sharon J Hammer
- UNMC College of Medicine, S 42nd St & Emile St, Omaha, NE, 68198, USA
| | - Carol H Pullen
- UNMC College of Nursing, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA
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16
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Kupzyk KA, Pozehl B, Pullen CH, Hageman PA. Behavior-Specific Cognitions Moderate Rural Women's Responsiveness to Web-Based Interventions for Weight Loss. J Nutr Educ Behav 2020; 52:474-482. [PMID: 32151439 PMCID: PMC9154085 DOI: 10.1016/j.jneb.2020.02.003] [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] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 01/31/2020] [Accepted: 02/06/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To examine whether baseline behavior-specific cognitions moderated the effects of 2 Web-based interventions with enhanced features on weight loss success in rural women. DESIGN Secondary analysis of behavior-specific cognition data from a community-based, randomized controlled trial, as potential moderators of weight loss over 30 months. PARTICIPANTS Women, overweight or obese, from rural communities, aged 40-69 years (n = 200). INTERVENTIONS Theory-based Web interventions, with enhanced features of either peer-led Web discussion or professional e-mail counseling. MAIN OUTCOME MEASURES Benefits and barriers to healthy eating and activity; self-efficacy and interpersonal support for healthy eating and activity using validated surveys; and weight. ANALYSIS Longitudinal multilevel models. RESULTS Women in the professional e-mail counseling group were more likely to lose weight if they perceived fewer barriers to and higher self-efficacy for healthy eating and activity. Greater weight loss in the peer-led discussion group was observed for women with lower self-efficacy and higher perceptions of barriers. Interpersonal support did not moderate the effects of the interventions. CONCLUSIONS AND IMPLICATIONS Although women in 2 different Web-enhanced interventions achieved similar weight loss, their baseline perceptions of behavior-specific cognitions moderated their relationship with the type of intervention and weight loss success. These findings, although exploratory, may assist in matching women to Web interventions that would best maximize weight loss success. Further research is needed.
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Affiliation(s)
- Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE.
| | - Bunny Pozehl
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Carol H Pullen
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Patricia A Hageman
- Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE
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17
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Eisenhauer CM, Brito FA, Yoder AM, Kupzyk KA, Pullen CH, Salinas KE, Miller J, Hageman PA. Mobile technology intervention for weight loss in rural men: protocol for a pilot pragmatic randomised controlled trial. BMJ Open 2020; 10:e035089. [PMID: 32295776 PMCID: PMC7200044 DOI: 10.1136/bmjopen-2019-035089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Men who are overweight or obese in the rural Midwestern USA are an unrepresented, at-risk group exhibiting rising rates of cardiovascular disease, poor access to preventive care and poor lifestyle behaviours that contribute to sedentary lifestyle and unhealthy diet. Self-monitoring of eating and activity has demonstrated efficacy for weight loss. Use of mobile technologies for self-monitoring eating and activity may address rural men's access disparities to preventive health resources and support weight loss. Our pilot trial will assess the feasibility and acceptability of two mobile applications for weight loss in rural men to inform a future, full-scale trial. METHODS AND ANALYSIS A 6-month randomised controlled trial with contextual evaluation will randomise 80 men using a 1:1 ratio to either a Mobile Technology Plus (MT+) intervention or a basic Mobile Technology (MT) intervention in rural, midlife men (aged 40-69 years). The MT+ intervention consists of a smartphone self-monitoring application enhanced with discussion group (Lose-It premium), short message service text-based support and Wi-Fi scale. The MT group will receive only a self-monitoring application (Lose-It basic). Feasibility and acceptability will be evaluated using number of men recruited and retained, and evaluative focus group feedback. We seek to determine point estimates and variability of outcome measures of weight loss (kg and % body weight) and improved dietary and physical activity behaviours (Behavioral Risk Factor Surveillance System (BRFSS) physical activity and fruit and vegetable consumption surveys, data from Lose-It! application (kcal/day, steps/day)). Community capacity will be assessed using standard best practice methods. Descriptive content analysis will evaluate intervention acceptability and contextual sensitivity. ETHICS AND DISSEMINATION This protocol was approved by the University of Nebraska Medical Center Institutional Review Board (IRB# 594-17-EP). Dissemination of findings will occur through ClinicalTrials.gov and publish pilot data to inform the design of a larger clinical trial. TRIAL REGISTRATION NUMBER NCT03329079; preresults. Protocol V.10, study completion date 31 August 2020. Roles and responsibilities funder: NIH/NINR Health Disparities Section 1R15NR017522-01.
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Affiliation(s)
- Christine M Eisenhauer
- College of Nursing- Northern Division, University of Nebraska Medical Center, Norfolk, Nebraska, USA
| | - Fabiana Almeida Brito
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Aaron M Yoder
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Carol H Pullen
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Katherine E Salinas
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jessica Miller
- College of Nursing- Northern Division, University of Nebraska Medical Center, Norfolk, Nebraska, USA
| | - Patricia A Hageman
- College of Allied Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
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18
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Miller JN, Berger AM, Kupzyk KA. Demographic, clinical, and biomarker predictors of apnea-hypopnea index from polysomnography in Midwestern sleep clinic patients. Sleep Breath 2020; 25:57-64. [PMID: 32193844 DOI: 10.1007/s11325-020-02053-w] [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] [Received: 01/10/2020] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND To examine if selected demographic (age, gender), clinical (diabetes, coronary artery disease, hyperlipidemia, myocardial infarction, stroke, lung disease, smoking history, alcohol intake), and biomarker [blood pressure (BP), heart rate, body mass index (BMI), neck circumference, Mallampati score] variables are predictors of apnea-hypopnea index (AHI) from polysomnography (PSG). METHODS This cross-sectional study recruited a sample of adults (N = 170) who were being evaluated for OSA. Participants completed self-reported demographic and clinical questionnaires, and then completed PSG (n = 142). Multi-collinearity was assessed. Confounding factors, correlations, and potential interactions were explored. RESULTS The final regression model was performed on 130 participants; 61 (46.9%) had an AHI ≥ 15. Systolic and diastolic BPs were highly correlated. Interactions were tested between gender and other variables (high cholesterol, BMI, neck circumference, systolic BP) and between systolic BP and other variables (high cholesterol, BMI, neck circumference, and lung disease). No interactions occurred between gender or systolic BP and other variables, meaning that the effects of the variables on AHI levels from PSG did not vary depending on gender or systolic BP. BMI, systolic BP, and absence of lung disease were predictors for AHI levels ≥ 15 from PSG. CONCLUSIONS BMI and systolic BP were significant predictors of OSA in this study. The absence of lung disease as a significant predictor was unique and may be due to the small number of participants who self-reported lung disease. To our knowledge, this is the first study to report this combination of variables to predict AHI levels ≥ 15 from PSG.
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Affiliation(s)
- Jennifer N Miller
- The University of Nebraska Medical Center College of Nursing, 550 N 19th St. #350R, Lincoln, NE, 68508, USA. .,Nebraska Pulmonary Specialties, LLC, 1500 S. 48th St. #800, Lincoln, NE, 68506, USA.
| | - Ann M Berger
- The University of Nebraska Medical Center College of Nursing, 550 N 19th St. #350R, Lincoln, NE, 68508, USA
| | - Kevin A Kupzyk
- The University of Nebraska Medical Center College of Nursing, 550 N 19th St. #350R, Lincoln, NE, 68508, USA
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19
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Norman JF, Kupzyk KA, Artinian NT, Keteyian SJ, Alonso WS, Bills SE, Pozehl BJ. The influence of the HEART Camp intervention on physical function, health-related quality of life, depression, anxiety and fatigue in patients with heart failure. Eur J Cardiovasc Nurs 2019; 19:64-73. [PMID: 31373222 DOI: 10.1177/1474515119867444] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Regular exercise training has beneficial effects on quality of life, physical function, depression and anxiety in individuals with heart failure. Unfortunately, individuals with heart failure have low levels of adherence to exercise. Thus, studies are needed to assess intervention strategies which may enhance clinical outcomes. AIM The aim of this study was to identify the components of the HEART Camp intervention, which contributed to optimizing clinical outcomes. METHODS The Heart Failure Exercise and Resistance Training Camp (HEART Camp) was a randomized controlled trial to evaluate the effect of a multicomponent intervention on adherence to exercise (6, 12 and 18 months) compared to an enhanced usual care group. This study assessed various components of the intervention on the secondary outcomes of physical function, health-related quality of life, depression, anxiety, and fatigue. RESULTS Individuals participating (n=204) in this study were 55.4% men and the average age was 60.4 (11.5) years. A combination of individualized and group-based strategies demonstrated clinical improvements, HEART Camp versus enhanced usual care groups, in physical function, positive trends in health-related quality of life and positive changes in the minimally important differences for depression, anxiety, and fatigue. CONCLUSIONS Individualized coaching by an exercise professional and group-based educational sessions were identified as important components of patient management contributing to improvements in the secondary outcomes of physical function, health-related quality of life, depression, anxiety and fatigue.
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Affiliation(s)
- Joseph F Norman
- College of Allied Health Professions, University of Nebraska Medical Center, USA
| | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, USA
| | | | | | - Windy S Alonso
- College of Nursing, University of Nebraska Medical Center, USA
| | - Sara E Bills
- College of Allied Health Professions, University of Nebraska Medical Center, USA
| | - Bunny J Pozehl
- College of Nursing, University of Nebraska Medical Center, USA
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20
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White LL, Kupzyk KA, Berger AM, Cohen MZ, Bierman PJ. Self-efficacy for symptom management in the acute phase of hematopoietic stem cell transplant: A pilot study. Eur J Oncol Nurs 2019; 42:21-27. [PMID: 31446260 DOI: 10.1016/j.ejon.2019.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/09/2019] [Accepted: 07/16/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE Hematopoietic stem cell transplant (HSCT) is an intensive treatment associated with distressing treatment and disease-related symptoms that affect patient outcomes such as functional status and quality of life. Self-efficacy for symptom management (SESM) is a person's belief in their ability to perform behaviors to prevent and relieve symptoms. Presence of SESM can impact symptom distress and functional status. This study describes the changes over time and relationships among SESM, symptom distress, and physical functional status in adults during the acute phase of HSCT. METHODS Patients (n = 40) completed measures of symptom distress, SESM, and physical function at time points prior to and at days 7, 15 and 30 post-transplant. Clinical outcomes were length of stay and number of readmissions. RESULTS Symptom distress, physical function, and SESM changed significantly over time. There was a significant negative relationship between symptom distress and physical function and between symptom distress and SESM at all points. The lowest levels of SESM and physical function were at day 7 when symptom distress was highest. Symptom distress was a moderator for the relationship between physical function and SESM at day 15. CONCLUSION This was the first study to examine SESM in the acute phase of HSCT. Higher SESM was associated with fewer symptoms and increased physical function. Less symptom distress was associated with higher physical function and confidence to manage symptoms. These findings provide the basis for development of patient-centered interventions to enhance SESM when symptoms are at their highest immediately after HSCT.
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Affiliation(s)
- Lynn L White
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198, USA; Avera McKennan Hospital and University Health Center, 1325 S Cliff Ave, Sioux Falls, SD, 57105, USA; Augustana University, 2001 S Summit Ave, Sioux Falls, SD, 57197, USA.
| | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Ann M Berger
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Marlene Z Cohen
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198, USA; VA Nebraska-Western Iowa Health Care System, 4101 Woolworth Ave, Omaha, NE, 68105, USA.
| | - Philip J Bierman
- College of Medicine, University of Nebraska Medical Center, Department of Internal Medicine, Division of Oncology & Hematology, 983332 Nebraska Medical Center, Omaha, NE, 68198, USA.
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21
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White LL, Cohen MZ, Berger AM, Kupzyk KA, Bierman PJ. Self-Efficacy for Management of Symptoms and Symptom Distress in Adults With Cancer: An Integrative Review. Oncol Nurs Forum 2019; 46:113-128. [PMID: 30547965 DOI: 10.1188/19.onf.113-128] [Citation(s) in RCA: 9] [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] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Self-efficacy for symptom management plays a key role in outcomes, such as quality of life (QOL), functional status, and symptom distress, for adults with cancer. This integrative review identified and assessed evidence regarding self-efficacy for management of symptoms and symptom distress in adults with cancer. LITERATURE SEARCH The authors performed a search of literature published from 2006-2018, and articles that examined the relationship among self-reported self-efficacy, symptom management, symptom distress or frequency, and severity in adults with cancer were selected for inclusion. DATA EVALUATION 22 articles met the inclusion criteria. All articles were critically appraised and met standards for methodologic quality. SYNTHESIS Evidence from this review showed that high self-efficacy was associated with low symptom occurrence and symptom distress and higher general health and QOL. High self-efficacy predicted physical and emotional well-being. Low self-efficacy was associated with higher symptom severity, poorer outcomes, and better overall functioning. IMPLICATIONS FOR RESEARCH Self-efficacy can be assessed using developed instruments. Presence of a theoretical model and validated instruments to measure self-efficacy for symptom management have set the groundwork for ongoing research.
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Affiliation(s)
| | - Marlene Z Cohen
- School of Nursing, University of Texas Health Science Center, Houston
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22
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Rowland SA, Cohen MZ, Pullen CH, Schulz PS, Berg KE, Kupzyk KA, Pozehl BJ, Yates BC. Vicarious Experience to Affect Physical Activity in Women: A Randomized Control Trial. West J Nurs Res 2019; 42:286-292. [PMID: 31204610 DOI: 10.1177/0193945919856575] [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: 11/15/2022]
Abstract
People compare themselves to others for self-evaluation, practical information, and motivation for healthy behaviors. The effect of active peer models on comparative thinking is unknown. The purpose of this 12-week, randomized, two-group pilot study was to evaluate the effect of a workplace peer modeling intervention on self-efficacy, motivation, and comparative thinking. The attention control group (ACG; n = 24) received general health information. The intervention group (n = 26) met with active peer models, received an exercise prescription and information. No significant group by time interaction effects were found. Comparisons on ability (how well am I doing), opinions (what should I think or believe), future self (think about my future), and modeling (be like someone else) all increased in the intervention group (n = 21) but decreased in the ACG (n = 22). Active peer models may support physical activity behavior change through specific lines of comparative thinking.
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23
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Tran DMT, Kupzyk KA, Zimmerman LM. Using Cluster Analysis to Identify Subgroups of College Students at Increased Risk for Cardiovascular Disease. J Nurs Meas 2018; 26:470-482. [PMID: 30593573 DOI: 10.1891/1061-3749.26.3.470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE To examine the co-occurrence of cardiovascular risk factors and cluster subgroups of college students for cardiovascular risks. METHODS A cross sectional descriptive study was conducted using co-occurrence patterns and hierarchical clustering analysis in 158 college students. RESULTS The top co-occurring cardiovascular risk factors were overweight/obese and hypertension (10.8%, n = 17). Of the total 34 risk factors that co-occurred, 30 of them involved being overweight/obese. A six-cluster-solution was obtained, two clusters displayed elevated levels of lifetime and 30-year cardiovascular disease risks. CONCLUSIONS The hierarchical cluster analysis identified that single White males with a family history of heart disease, overweight/obese, hypertensive or diabetes, and occasionally (weekly) consumed red meat, take antihypertensive medication, and hyperlipidemia were considered the higher risk group compared to other subgroups.
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Affiliation(s)
- Dieu-My T Tran
- University of Nevada, Las Vegas School of Nursing, Las Vegas, Nevada
| | - Kevin A Kupzyk
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska
| | - Lani M Zimmerman
- University of Nebraska Medical Center College of Nursing, Lincoln, Nebraska
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24
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Abstract
BACKGROUND Many chronic conditions, including heart disease, cancer, and rheumatoid arthritis, are associated with underlying chronic inflammatory processes. Literature reviews have analyzed a variety of integrative therapies and their relationships with chronic inflammation. This systematic review is unique in reporting solely on yoga's relationship with inflammation. Its purpose was to synthesize current literature examining the impact of yoga interventions on inflammatory biomarkers in adults with chronic inflammatory-related disorders. METHOD Searches of several electronic databases were conducted. Inclusion criteria were (a) English language, (b) sample age >18 years old, (c) yoga interventions involving postures with or without yoga breathing and/or meditation, and (d) measured inflammatory biomarkers. RESULTS The final review included 15 primary studies. Of these, seven were rated as excellent and eight as average or fair. There was considerable variability in yoga types, components, frequency, session length, intervention duration, and intensity. The most common biomarkers measured were interleukin-6 ( n = 11), C-reactive protein ( n = 10), and tumor necrosis factor ( n = 8). Most studies reported positive effects on inflammatory biomarkers ( n = 11) from baseline to post yoga intervention. Analysis of the dose showed higher total dose (>1,000 min) resulted in greater improvements in inflammation. CONCLUSION This review suggests that yoga can be a viable intervention to reduce inflammation across a multitude of chronic conditions. Future studies with detailed descriptions of yoga interventions, measurement of new and well-established inflammatory biomarkers, and larger sample sizes are warranted to advance the science and corroborate results.
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Affiliation(s)
- Dilorom M Djalilova
- 1 Omaha Division, College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Paula S Schulz
- 2 Lincoln Division, College of Nursing, University of Nebraska Medical Center, Lincoln, NE, USA
| | - Ann M Berger
- 1 Omaha Division, College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Adam J Case
- 3 Department of Cellular and Integrative Physiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kevin A Kupzyk
- 1 Omaha Division, College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Alyson C Ross
- 4 Nursing Department, National Institutes of Health Clinical Center, Bethesda, MD, USA
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25
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Niitsu K, Rice MJ, Houfek JF, Stoltenberg SF, Kupzyk KA, Barron CR. A Systematic Review of Genetic Influence on Psychological Resilience. Biol Res Nurs 2018; 21:61-71. [DOI: 10.1177/1099800418800396] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
When exposed to adversity, some individuals are at an increased risk of posttraumatic stress disorder, experiencing persistent biopsychosocial disturbances, whereas others adapt well, described as resilience. Resilience is a complex biopsychosocial phenomenon conceptualized as adaptation to adversity influenced by an individual’s genetic variants, epistasis, epigenetics, and gene-by-environment interactions. Studies on psychological resilience have focused on behavioral and psychosocial variables with far less examination of the genetic contributions. The purpose of this review is to identify specific genetic variants contributing to the biological capacity for psychological resilience. PubMed and PsycINFO were searched using the following key words: psychological resilience AND genotype(s). Additional articles were identified from the Human Genome Epidemiology Navigator using the term resilience, psychological. Ten studies met the criteria. Six genes were empirically associated with psychological resilience: serotonin-transporter-linked polymorphic region ( 5-HTTLPR), dopamine receptor D4, brain-derived neurotrophic factor ( BDNF), corticotropin-releasing hormone receptor 1, oxytocin receptor and regulator of G-protein signaling 2 . The findings of this systematic review suggest that the L/L or L’/L’ genotype of 5-HTTLPR and rs25531 in children/adolescents and the S/S or S’/S’ genotype in adults are most frequently related to resilience. Additionally, the Val/Val genotype of rs6265 in BDNF in Caucasians was also associated with resilience. There are numerous factors contributing to the complexity of determining the genetic influence on resilience including analysis of rs25531, assumptions of the mode of inheritance, operationalization of resilience, demographic and population characteristics, sample size, and other types of genetic influence including epistasis and epigenetics. While current evidence is supportive, further investigation of the genetic influence on resilience is required.
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Affiliation(s)
- Kosuke Niitsu
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Michael J. Rice
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Julia F. Houfek
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Kevin A. Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Cecilia R. Barron
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
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26
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Cramer ME, Mollard EK, Ford AL, Kupzyk KA, Wilson FA. The feasibility and promise of mobile technology with community health worker reinforcement to reduce rural preterm birth. Public Health Nurs 2018; 35:508-516. [PMID: 30216526 DOI: 10.1111/phn.12543] [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] [Received: 05/11/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES (1) Assess feasibility of a smartphone platform intervention combined with Community Health Worker (CHW) reinforcement in rural pregnant women; (2) Obtain data on the promise of the intervention on birth outcomes, patient activation, and medical care adherence; and (3) Explore financial implications of the intervention using return on investment (ROI). SAMPLE A total of 98 rural pregnant women were enrolled and assigned to intervention or control groups in this two-group experimental design. INTERVENTION The intervention group received usual prenatal care plus a smartphone preloaded with a tailored prenatal platform with automated texting, chat function, and hyperlinks and weekly contact from the CHW. The control group received usual prenatal care and printed educational materials. MEASUREMENTS Demographics, health risk data, interaction with platform, medical records, hospital billing charges, Client Satisfaction Questionnaire-8, satisfaction comments, and the Patient Activation Measure. RESULTS A total of 77 women completed the study. The intervention was well-received, showed promise for improving birth outcomes, patient activation, and medical care adherence. Financial analysis showed a positive ROI under two scenarios. CONCLUSIONS Despite several practical issues, the study appears feasible. The intervention shows promise for extending prenatal care and improving birth outcomes in rural communities. Further research is needed with a larger and more at-risk population to appreciate the impact of the intervention.
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Affiliation(s)
- Mary E Cramer
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska
| | | | - Amy L Ford
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska
| | - Kevin A Kupzyk
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska
| | - Fernando A Wilson
- University of Nebraska Medical Center College of Public Health, Omaha, Nebraska
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Berger AM, Kupzyk KA, Djalilova DM, Cowan KH. Breast Cancer Collaborative Registry informs understanding of factors predicting sleep quality. Support Care Cancer 2018; 27:1365-1373. [PMID: 30112722 DOI: 10.1007/s00520-018-4417-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 03/26/2018] [Accepted: 08/08/2018] [Indexed: 12/31/2022]
Abstract
SIGNIFICANCE Poor sleep quality is a common and persistent problem reported by women with breast cancer (BC). Empirical evidence identifies many risk factors for self-reported sleep deficiency, but inconsistencies limit translation to practice. PURPOSE To increase understanding of risk factors predicting self-reported poor sleep quality in women with BC who completed the Breast Cancer Collaborative Registry (BCCR) questionnaire. METHODS This cross-sectional study recruited women with a first diagnosis of BC (n = 1302) at five sites in Nebraska and South Dakota. Women completed the BCCR that includes numerous variables as well as the Pittsburgh Sleep Quality Index (PSQI) and SF36v2 (n = 1260). Descriptive statistics and non-parametric correlations were used to determine associations and create predictive models of sleep quality with BCCR variables and SF36v2 subscales. RESULTS Most women were white (93.7%) and married (71.5%); mean age was 60.1 (21-90) years. Poor sleep was self-reported by 53% of women. Seven variables were highly associated with sleep quality (p ≤ 0.001). The first model found younger age, lower physical activity, and higher fatigue were the strongest combined and independent variables predicting poor sleep quality (F = 23.0 (p < .001), R2 = 0.103). Participants self-reported lower health status on most SF36v2 subscales [Z = 44.9 (11.6) to 49.1 (10.1)]. A second model found that all subscales were predictors of poor sleep; vitality, mental health, bodily pain, and general health were the strongest predictors (F = 101.3 (p < .001), R2 = 0.26). CONCLUSIONS Results confirm previously identified risk factors and reveal inconsistencies in other variables. Clinicians need to routinely screen for the identified risk factors of self-reported poor sleep quality.
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Affiliation(s)
- Ann M Berger
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Kenneth H Cowan
- Eppley Institute, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
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Miller JN, Kupzyk KA, Zimmerman L, Pozehl B, Schulz P, Romberger D, Berger AM. Comparisons of measures used to screen for obstructive sleep apnea in patients referred to a sleep clinic. Sleep Med 2018; 51:15-21. [PMID: 30077956 DOI: 10.1016/j.sleep.2018.06.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 12/15/2017] [Accepted: 06/18/2018] [Indexed: 02/08/2023]
Abstract
STUDY OBJECTIVES Obstructive Sleep Apnea (OSA) contributes to all-cause mortality. An American Academy of Sleep Medicine task force is focusing on improving detection and categorization of OSA symptoms and severity to promote screening, assessment, and diagnosis. The purpose of this study was to psychometrically compare measures used in OSA screening (Berlin, Epworth Sleepiness Scale (ESS), STOP Bang) and a portable sleep monitor (PSM) to apnea-hypopnea index (AHI) and levels from polysomnogram (PSG). METHODS An observational, cross-sectional design was used. Patients referred to a sleep specialist were enrolled at initial sleep evaluation. Participants completed measures used in OSA screening, then sent home for one night using PSM. PSGs were ordered by the physician and AHI results were obtained from the medical record. RESULTS Participants (N = 170) were enrolled in the study. Almost all participants completed the OSA measures, approximately half-completed PSM measurement, and the majority completed laboratory PSG. The STOP Bang had the highest levels of sensitivity; the ESS had the lowest. The ESS had the highest specificity and reliability levels; the STOP Bang had the lowest. The PSM measure had the highest positive predictive value (PPV) and the strongest psychometric properties of the screening measures. CONCLUSIONS The STOP Bang was the preferred self-report OSA screening measure because of high levels of sensitivity. The ESS was the least desirable measure. PSM measurement consistently predicted the presence of OSA but at the expense of low sensitivity at AHI levels ≥30. This expands the knowledge of validity testing of screening measures used for OSA.
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Affiliation(s)
- Jennifer N Miller
- Nebraska Pulmonary Specialties, LLC, 1500 S. 48th St. #800, Lincoln, NE, 68506, USA.
| | - Kevin A Kupzyk
- The University of Nebraska Medical Center College of Nursing, 985330 Nebraska Medical Center, 4111 Dewey Avenue, Omaha, NE, USA
| | - Lani Zimmerman
- The University of Nebraska Medical Center College of Nursing, 985330 Nebraska Medical Center, 4111 Dewey Avenue, Omaha, NE, USA
| | - Bunny Pozehl
- The University of Nebraska Medical Center College of Nursing, 985330 Nebraska Medical Center, 4111 Dewey Avenue, Omaha, NE, USA
| | - Paula Schulz
- The University of Nebraska Medical Center College of Nursing, 985330 Nebraska Medical Center, 4111 Dewey Avenue, Omaha, NE, USA
| | - Debra Romberger
- The University of Nebraska Medical Center College of Nursing, 985330 Nebraska Medical Center, 4111 Dewey Avenue, Omaha, NE, USA
| | - Ann M Berger
- The University of Nebraska Medical Center College of Nursing, 985330 Nebraska Medical Center, 4111 Dewey Avenue, Omaha, NE, USA
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Rowland SA, Berg KE, Kupzyk KA, Pullen CH, Cohen MZ, Schulz PS, Yates BC. Feasibility and Effect of a Peer Modeling Workplace Physical Activity Intervention for Women. Workplace Health Saf 2018; 66:428-436. [DOI: 10.1177/2165079917753690] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Most working women do not meet current guidelines for physical activity (PA). A 12-week pilot study tested a workplace, peer modeling PA intervention. Inactive female employees from a health system were randomized to an attention control group (ACG; n = 26) or an intervention group (IG; n = 26). The ACG received health information. The IG participated in six group sessions with an active peer model and received an exercise prescription and PA information. Pre and post measures were PA (ActiGraph), Estimated VO2max (cycle ergometer), resting heart rate (HR), glucose and lipids, and cardiovascular risk. Using hierarchical linear modeling, no significant group by time effects were found. Although PA increased in both groups, F( df = 1) = 11.4, p = .002, the IG had greater improvements in fitness (VO2max, HR) and cardiovascular risk (total cholesterol, triglyceride, low density lipoprotein [LDL], calculated risk score) compared with ACG. Results support repeating this intervention in a fully powered study.
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Brown SG, Hudson DB, Campbell-Grossman C, Kupzyk KA, Yates BC, Hanna KM. Social Support, Parenting Competence, and Parenting Satisfaction Among Adolescent, African American, Mothers. West J Nurs Res 2018; 40:502-519. [PMID: 28322635 PMCID: PMC5453843 DOI: 10.1177/0193945916682724] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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] [Indexed: 11/16/2022]
Abstract
This secondary analysis explored how social support changed during the first 6 months postpartum and examined the relationships among social support, parenting competence, and parenting role satisfaction. Single, low-income, adolescent, new mothers ( N = 34) completed measures of perceived parenting competence, parenting role satisfaction, and four types of received social support (emotional, informational, tangible, problematic) from the entire social network at 1 week, 6 weeks, 3 months, and 6 months postpartum. Results indicated that social support did not change over time. Emotional, informational, and tangible social support were significantly correlated, concurrently and predictively, with perceived competence and satisfaction at most data collection points. Future social support intervention studies using social support as a modifiable variable with this high-risk group of African American adolescent new mothers are advocated. Health care professionals are encouraged to examine existing social support within these mothers' identified family units.
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Affiliation(s)
- Sara G Brown
- 1 University of Nebraska Medical Center, Omaha, USA
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Hulme PA, Kupzyk KA, Anthone GJ, Capron KA, Nguyen T. Weight Loss and Timing of J Tube Removal in Biliopancreatic Diversion with Duodenal Switch Patients Who Report Physical or Sexual Abuse. Obes Surg 2018; 28:2361-2367. [PMID: 29512037 DOI: 10.1007/s11695-018-3166-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Bariatric surgery patients who report physical or sexual abuse form a sizeable cohort that stands out due to psychological comorbidity. Their possible vulnerability to suboptimal weight loss remains of interest. Their risk for malnutrition due to inadequate oral intake following surgery is underexplored. OBJECTIVES Study aims were to determine the effect of self-reported physical or sexual abuse in patients undergoing open biliopancreatic diversion with duodenal switch (BPD/DS) on (a) 3-year weight loss trajectories and (b) timing of feeding jejunostomy tube (J tube) removal. Delayed J tube removal served as an indicator for inadequate oral intake. METHODS In this retrospective cohort study, the sample (N = 189) consisted of all patients who underwent primary BPD/DS by the same surgeon during 2009 and 2010 at a Midwestern health system. All patients had a J tube placed during surgery. Longitudinal mixed models were used for testing differences in weight loss trajectories by abuse status. RESULTS There were no significant differences in weight loss trajectories by abuse status. The abused group had the J tube in place a mean of 61.9 days (SD = 39.5) compared to 44.8 days (SD = 32.8) for the not abused group, a significant difference. CONCLUSIONS Our use of the best available statistical methods lends validity to previous findings that suggest physical or sexual abuse does not affect weight loss after bariatric surgery. Increased likelihood of persistent inadequate oral intake in the abused group suggests the need for early multidisciplinary interventions that include mental health and nutrition experts.
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Affiliation(s)
- Polly A Hulme
- College of Nursing, South Dakota State University, Wagner Hall 204, Brookings, SD, 57007, USA.
| | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA
| | - Gary J Anthone
- Department of Surgery, Creighton University, 10506 Burt Circle, Omaha, NE, 68144, USA
| | | | - Thang Nguyen
- Nebraska Medicine, 987400 Nebraska Medical Center, Omaha, NE, 68198-7400, USA
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Berger AM, Buzalko RJ, Kupzyk KA, Gardner BJ, Djalilova DM, Otte JL. Preferences and actual chemotherapy decision-making in the greater plains collaborative breast cancer study . Acta Oncol 2017; 56:1690-1697. [PMID: 28903664 DOI: 10.1080/0284186x.2017.1374555] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION There is renewed interest in identifying breast cancer patients' participation in decision-making about adjuvant chemotherapy. There is a gap in the literature regarding the impact of these decisions on quality of life (QOL) and quality of care (QOC). Our aims were to determine similarities and differences in how patients diagnosed with breast cancer preferred to make decisions with providers about cancer treatment, to examine the patient's recall of her role when the decision was made about chemotherapy and to determine how preferred and actual roles, as well as congruence between them, relate to QOL and perceived QOC. MATERIAL AND METHODS Greater Plains Collaborative clinical data research network of PCORnet conducted the 'Share Thoughts on Breast Cancer' survey among women 12-18 months post-diagnosis at eight sites in seven Midwestern United States. Patients recalled their preferred and actual treatment decision-making roles and three new shared decision-making (SDM) variables were created. Patients completed QOL and QOC measurements. Correlations and t-tests were used. RESULTS Of 1235 returned surveys, 873 (full sample) and 329 (subsample who received chemotherapy) were used. About one-half of women in both the full (50.7%) and subsample (49.8%,) preferred SDM with providers about treatment decisions, but only 41.2% (full) and 42.6% (subsample) reported experiencing SDM. Significant differences were found between preferred versus actual roles in the full (p < .001) and subsample (p < .004). In the full sample, there were no relationships between five decision-making variables with QOL, but there was an association with QOC. The subsample's decision-making variables related to several QOL scales and QOC items, with a more patient-centered decision than originally preferred related to higher physical and social/family well-being, overall QOL and QOC. CONCLUSIONS Patients benefit from providers' efforts to identify patient preferences, encourage an active role in SDM, and tailor decision making to their desired choice.
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Affiliation(s)
- Ann M. Berger
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Russell J. Buzalko
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kevin A. Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Bret J. Gardner
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Julie L. Otte
- School of Nursing, Indiana University, Indianapolis, IN, USA
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Cohen MZ, Kupzyk KA, Holley LM, Katzman RM. Measuring Resilience in Two Generations: Psychometric Properties of Available Instruments. J Nurs Meas 2017; 25:332-352. [PMID: 28789755 DOI: 10.1891/1061-3749.25.2.332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE This study examines measures of resilience to identify the best available measure for future research to assess efficacy of a low-cost intervention that enhances resilience of older adults and youth (i.e., intergenerational transfer of ethnic culture). METHODS Scanning the literature produced no obvious choice; 3 measures showed promise: the Wagnild-Young Resilience Scale, Windle-Markland-Woods Psychological Resilience Scale, and the Connor-Davidson Resilience Scale (CD-RISC); 200 ethnicityalike older adults and 192 youths completed all three scales. RESULTS Factor analyses interpreted in consultation with a panel of community advisers showed no measure was statistically robust. The CD-RISC had acceptable reliability and a conceptually interpretable structure. CONCLUSIONS Results suggest the CD-RISC, supplemented by qualitative input, provides a way forward for research on efficacy of intergenerational interventions.
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Abstract
Although clinicians and researchers are interested in the phenomenon of resilience, there is no agreed-upon definition of resilience. Scientific evidence suggests that resilience is influenced by intrapersonal (e.g. personality traits) and environmental (e.g. social support) variables. A concept analysis was conducted to better understand the meaning of resilience. In this analysis, the antecedent of resilience was a potentially traumatic event; the defining attributes were ego-resiliency, emotion regulation, social support, and heredity; and the consequences were none to mild psychopathological symptoms and positive adaptation. This analysis can help nurses better understand resilience and its relationships to both intrapersonal and environmental variables.
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Affiliation(s)
- Kosuke Niitsu
- a College of Nursing , University of Nebraska Medical Center , Omaha , NE , USA
| | - Julia F Houfek
- a College of Nursing , University of Nebraska Medical Center , Omaha , NE , USA
| | - Cecilia R Barron
- a College of Nursing , University of Nebraska Medical Center , Omaha , NE , USA
| | - Scott F Stoltenberg
- b Department of Psychology , University of Nebraska-Lincoln , Lincoln , NE , USA
| | - Kevin A Kupzyk
- a College of Nursing , University of Nebraska Medical Center , Omaha , NE , USA
| | - Michael J Rice
- c College of Nursing , University of Colorado Anschutz Medical Campus , Aurora , Colorado , USA
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Tran DMT, Zimmerman LM, Kupzyk KA, Shurmur SW, Pullen CH, Yates BC. Cardiovascular risk factors among college students: Knowledge, perception, and risk assessment. J Am Coll Health 2017; 65:158-167. [PMID: 27911653 DOI: 10.1080/07448481.2016.1266638] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To assess college students' knowledge and perception of cardiovascular risk factors and to screen for their cardiovascular risks. PARTICIPANTS The final sample that responded to recruitment consisted of 158 college students from a midwestern university. METHODS A cross-sectional, descriptive study was performed using convenience sampling. RESULTS College students were knowledgeable about cardiovascular risk factors but did not perceive themselves at risk for cardiovascular disease (CVD). Knowledge of cardiovascular risk factors was correlated with the lifetime risk estimates (ρ = .17, p = .048), and perception of cardiovascular risk was positively associated with 30-year CVD risk estimates (ρ = .16, p = .048). More than 50% of the participants had 1 or more cardiovascular risk factors. CONCLUSIONS High knowledge level of cardiovascular risk factors was not sufficient to lower cardiovascular risks within this study population, but changing perception of cardiovascular risk factors may play a bigger role in reducing long-term cardiovascular risks.
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Affiliation(s)
- Dieu-My T Tran
- a School of Nursing , University of Nevada , Las Vegas , Las Vegas , Nevada , USA
| | - Lani M Zimmerman
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
| | - Kevin A Kupzyk
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
| | - Scott W Shurmur
- c School of Medicine , Texas Tech University Health Sciences Center , Lubbock , Texas , USA
| | - Carol H Pullen
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
| | - Bernice C Yates
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
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Kwon K, Hanrahan AR, Kupzyk KA. Emotional expressivity and emotion regulation: Relation to academic functioning among elementary school children. School Psychology Quarterly 2017; 32:75-88. [DOI: 10.1037/spq0000166] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kotcherlakota S, Kupzyk KA, Rejda P. Years of Experience as a Predictor of Nurse Faculty Technology Use. J Nurs Educ 2017; 56:115-119. [DOI: 10.3928/01484834-20170123-09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 09/02/2016] [Indexed: 11/20/2022]
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Bilek LD, Waltman NL, Lappe JM, Kupzyk KA, Mack LR, Cullen DM, Berg K, Langel M, Meisinger M, Portelli-Trinidad A, Lang M. Protocol for a randomized controlled trial to compare bone-loading exercises with risedronate for preventing bone loss in osteopenic postmenopausal women. BMC Womens Health 2016; 16:59. [PMID: 27576310 PMCID: PMC5004254 DOI: 10.1186/s12905-016-0339-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 09/17/2015] [Accepted: 08/19/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND In the United States, over 34 million American post-menopausal women have low bone mass (osteopenia) which increases their risk of osteoporosis and fractures. Calcium, vitamin D and exercise are recommended for prevention of osteoporosis, and bisphosphonates (BPs) are prescribed in women with osteoporosis. BPs may also be prescribed for women with low bone mass, but are more controversial due to the potential for adverse effects with long-term use. A bone loading exercise program (high-impact weight bearing and resistance training) promotes bone strength by preserving bone mineral density (BMD), improving bone structure, and by promoting bone formation at sites of mechanical stress. METHODS/DESIGN The sample for this study will be 309 women with low bone mass who are within 5 years post-menopause. Subjects are stratified by exercise history (≥2 high intensity exercise sessions per week; < 2 sessions per week) and randomized to a control or one of two treatment groups: 1) calcium + vitamin D (CaD) alone (Control); 2) a BP plus CaD (Risedronate); or 3) a bone loading exercise program plus CaD (Exercise). After 12 months of treatment, changes in bone structure, BMD, and bone turnover will be compared in the 3 groups. Primary outcomes for the study are bone structure measures (Bone Strength Index [BSI] at the tibia and Hip Structural Analysis [HSA] scores). Secondary outcomes are BMD at the hip and spine and serum biomarkers of bone formation (alkaline phosphase, AlkphaseB) and resorption (Serum N-terminal telopeptide, NTx). Our central hypothesis is that improvements in bone strength will be greater in subjects randomized to the Exercise group compared to subjects in either Control or Risedronate groups. DISCUSSION Our research aims to decrease the risk of osteoporotic fractures by improving bone strength in women with low bone mass (pre-osteoporotic) during their first 5 years' post-menopause, a time of rapid and significant bone loss. Results of this study could be used in developing a clinical management pathway for women with low bone mass at their peak period of bone loss that would involve lifestyle modifications such as exercises prior to medications such as BPs. TRIAL REGISTRATION Clinicaltrials.gov NCT02186600 . Initial registration: 7/7/2014.
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Affiliation(s)
- Laura D Bilek
- College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
| | - Nancy L Waltman
- College of Nursing, University of Nebraska Medical Center, 1230 O Street, Suite 131, Lincoln, NE, 68588-0220, USA.
| | - Joan M Lappe
- Creighton Osteoporosis Research Center, 601 North 30th, Omaha, NE, 68131, USA
| | - Kevin A Kupzyk
- Center for Nursing Science, University of Nebraska Medical Center, 4101 Dewey Avenue, Omaha, NE, 68198-5330, USA
| | - Lynn R Mack
- Diabetes, Endocrinology, & Metabolism, Nebraska Medicine, Omaha, NE, 68198-4130, USA
| | - Diane M Cullen
- Biomedical Science, Creighton University, Omaha, NE, 68102, USA
| | - Kris Berg
- School of HPER, University of Nebraska at Omaha, Omaha, NE, 68162-0216, USA
| | - Meghan Langel
- Heartland Osteoporosis Research Study, College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
| | - Melissa Meisinger
- Heartland Osteoporosis Research Study, College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
| | - Ashlee Portelli-Trinidad
- Heartland Osteoporosis Research Study, College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
| | - Molly Lang
- College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
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Kupzyk KA, Seo Y, Yates B, Pozehl B, Norman J, Lowes B. Use of the Late-Life Function and Disability Instrument for Measuring Physical Functioning in Patients With Heart Failure. J Nurs Meas 2016; 24:323-36. [PMID: 27535318 DOI: 10.1891/1061-3749.24.2.323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE We evaluated the psychometric properties of the functioning component of the Late-Life Function and Disability Instrument (LLFDI) in individuals with heart failure (HF). METHODS Factor analyses were used (N = 151) to assess the dimensionality and structure of the basic and advanced lower extremity function subscales. Rasch model scores were compared to the raw means of the items. RESULTS Rasch scores correlated with the raw means of the items at r = .96, indicating raw means are comparable to the more complicated Rasch analysis in estimating physical functioning using the basic and advanced subscales. CONCLUSIONS The lower extremity physical functioning subscales of the LLFDI have potential as a clinical assessment tool to identify HF patients who are at high risk for functional limitations.
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Affiliation(s)
- Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha
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Campbell-Grossman C, Hudson DB, Kupzyk KA, Brown SE, Hanna KM, Yates BC. Low-Income, African American, Adolescent Mothers' Depressive Symptoms, Perceived Stress, and Social Support. J Child Fam Stud 2016; 25:2306-2314. [PMID: 28413312 PMCID: PMC5389114 DOI: 10.1007/s10826-016-0386-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this descriptive repeated-measures study was to describe depressive symptom patterns and report changes over time in levels of perceived stress and social support depending on patterns of depressive symptoms in single, low-income, African American, adolescent mothers during the initial, 6-month postpartum period. Thirty-five adolescent subjects between the ages of 16 and 22 years old were recruited at health care clinics in two Midwestern cities. Data collections by advanced practice nurses were completed at 1 week, 6 weeks, 3 months, and 6 months postpartum at mothers' homes. Established instruments were used to measure depressive symptoms, perceived stress and social support. Results indicated 63% of adolescent mothers' experienced depressive symptoms sometime during this transition period and 11.4% of these subjects had depressive symptoms at all 4 time points. Depressive symptoms were associated with perceived stress at each time point. Emotional support was inversely associated with depressive symptoms at 2 of the 4 time points. Depressive symptoms and problematic support were significantly related at 3 months and 6 months. Although single, low-income, African American, adolescent mothers are considered a high risk group, some are at even greater risk. This extremely high risk group have depressive symptoms throughout the first 6 months postpartum with the highest level of perceived stress and the most variability in social support relative to groups that were never depressed or were in and out of depression. More studies are needed to understand how to best help these high risk adolescents successfully transition to motherhood.
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Affiliation(s)
| | | | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Sara E Brown
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Kathleen M Hanna
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Bernice C Yates
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
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Hulme PA, McBride CL, Kupzyk KA, French JA. Pilot Study on Childhood Sexual Abuse, Diurnal Cortisol Secretion, and Weight Loss in Bariatric Surgery Patients. J Child Sex Abus 2015; 24:385-400. [PMID: 26061023 PMCID: PMC5996386 DOI: 10.1080/10538712.2015.1022293] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Childhood sexual abuse increases risk for adult obesity. A potential contributing factor is altered cortisol secretion. In this pilot study, relationships among childhood sexual abuse, diurnal salivary cortisol secretion, and weight loss were explored in 17 bariatric surgery patients. Measurement points were before surgery (baseline) and 3 and 6 months after surgery. Childhood sexual abuse was measured by the Childhood Trauma Questionnaire. The results showed moderate but nonsignificant positive correlations between the childhood sexual abuse subscale score and baseline morning cortisol, evening cortisol, and daily mean cortisol. An unexpected positive correlation was noted between the Childhood Trauma Questionnaire total score and weight loss at six months. Diurnal cortisol secretion did not change over time after surgery nor correlate significantly with weight loss at six months.
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Affiliation(s)
- Polly A Hulme
- a South Dakota State University , Brookings , South Dakota , USA
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Mathews TL, King ML, Kupzyk KA, Lake CM. Findings and implications of developmental screening for high-risk children referred to a tertiary developmental disability center. J Pediatr Health Care 2014; 28:507-15. [PMID: 24793986 DOI: 10.1016/j.pedhc.2014.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 03/02/2014] [Accepted: 03/11/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The primary goal of this article is to describe an intake process and results of screening for developmental and autism spectrum disorders in children referred to a tertiary center. A secondary analysis of abnormal screening results, demographic variables, and parental concerns of autism was conducted, along with a correlation analysis between developmental and autism-specific screening tools. METHODS A total of 379 children younger than 6 years were "prescreened" with the Ages and Stages Questionnaire-3 and the Modified Checklist for Autism in Toddlers or the Social Communication Questionnaire. Medical records were reviewed to identify demographic variables and parental primary concerns. RESULTS In approximately 11% of participants who screened positive for autism, no parental concerns of autism were present. Medium effect size correlations were found between the failed autism screening tools and delays in two domains on the Ages and Stages Questionnaire-3. DISCUSSION Clinical implications are addressed concerning diligent use of developmental and autism-specific rating scales to identify children at risk.
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Yates BC, Rowland S, Mancuso K, Kupzyk KA, Norman JF, Shurmur S, Tesina K. Reducing Cardiovascular Risk in Spouses of Cardiac Patients. West J Nurs Res 2014; 37:85-102. [DOI: 10.1177/0193945914551390] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Few studies have examined risk-reducing interventions in spouses of coronary artery bypass patients. This study examined the effects of the Partners Together in Health (PaTH) intervention versus usual care on cardiovascular risk factors. Spouses in the experimental group ( n = 17/group) attended cardiac rehabilitation with patients and made the same physical activity and healthy eating changes as patients. Spouses in the usual care group attended educational classes with patients. Spouses’ 30-year cardiovascular risk was calculated using the Lifetime Risk Scale before and after cardiac rehabilitation (3 months), and at 6 months. Spouses in both groups significantly reduced 30-year risk scores at 3 and 6 months. Exercise was the key ingredient in lowering risk. There was a trend toward reduction in systolic blood pressure and an increase in high-density lipoprotein cholesterol in both groups. Although there were no group differences, having spouses participate in cardiac rehabilitation with the patient was effective for reducing spouses’ cardiovascular risk.
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Abstract
Data entry can result in errors that cause analytic problems and delays in disseminating research. Invalid responses can lead to incorrect statistics and statistical conclusions. The purpose of this article is to provide researchers some basic strategies for avoiding out-of-range data entry errors and streamlining data collection. This article identifies some basic strategies using Microsoft® Excel, which is an inexpensive method of data entry that can be used when research budgets are constrained. Data files can be structured so that out-of-range values cannot be entered. When string variables are entered, researchers may be inconsistent in the way they code responses. Data validation can be accomplished through the use of restricting response options and skipping items can be avoided by using count functions to tabulate the number of valid responses. We also discuss advantages and disadvantages of several methods of data entry, including using web-based data entry and relational databases.
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Burt JD, Garbacz SA, Kupzyk KA, Frerichs L, Gathje R. Examining the utility of behavioral health integration in well-child visits: implications for rural settings. Fam Syst Health 2014; 32:20-30. [PMID: 24684153 DOI: 10.1037/a0035121] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this study was to assess the effect of integrating behavioral health services into well-child visits in underserved, remote, and/or fringe areas. Specifically, the following were examined: the structure of the well-child visit for standard care in comparison to when a behavioral health provider was integrated into the visit and the effect of integrating a behavioral health provider on behavioral health topics covered and parent satisfaction. Participants were 94 caregivers of children attending well-child visits. Group differences were examined for participants in well-child visits with a behavioral health provider and participants in a standard well-child visit. Findings suggest a statistically significant increase in caregiver-rated perception for the number of topics covered with the integration of a behavioral health provider in the well-child visits. No significant effects of caregiver-rated helpfulness or satisfaction were observed. Implications for the findings and future research directions are discussed.
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Affiliation(s)
| | - S Andrew Garbacz
- Department of Special Education and Clinical Sciences, University of Oregon
| | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center
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Sheridan SM, Knoche LL, Edwards CP, Kupzyk KA, Clarke BL, Kim EM. Efficacy of the Getting Ready Intervention and the Role of Parental Depression. Early Educ Dev 2014; 25:746-769. [PMID: 25018615 PMCID: PMC4091849 DOI: 10.1080/10409289.2014.862146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study reports the results of a randomized trial of a parent engagement intervention (the Getting Ready Project) on directly observed learning-related social behaviors of children from families of low-income in the context of parent-child interactions. The study explored the moderating effect of parental depression on intervention outcomes. Participants were 204 children and their parents, and 29 Head Start teachers. Semi-structured parent-child interaction tasks were videotaped two times annually over the course of two academic years. Observational codes of child behaviors included agency, persistence, activity level, positive affect, distractibility, and verbalizations. Controlling for gender and disability concerns, relative to children in the control group, those in the treatment condition experienced a significant decline in activity level. Furthermore, compared to children of non-depressed mothers and to control children, those in the experimental condition whose parent reported elevated levels of depression showed greater gains in positive affect and in verbalizations.
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Affiliation(s)
| | - Lisa L Knoche
- Nebraska Center for Reserach on Children, Youth, Families and Schools, University of Nebraska - Lincoln
| | - Carolyn P Edwards
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln
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Mathews TL, Erkfritz-Gay KN, Knight J, Lancaster BM, Kupzyk KA. The Effects of Social Skills Training on Children With Autism Spectrum Disorders and Disruptive Behavior Disorders. Children's Health Care 2013. [DOI: 10.1080/02739615.2013.842458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Knoche LL, Edwards CP, Sheridan SM, Kupzyk KA, Marvin CA, Cline KD, Clarke BL. Getting Ready: Results of a Randomized Trial of a Relationship-Focused Intervention on the Parent-Infant Relationship in Rural Early Head Start. Infant Ment Health J 2012; 33:669. [PMID: 28520123 DOI: 10.1002/imhj.21377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Lisa L Knoche
- University of Nebraska-Lincoln, Nebraska Center for Research on Children, Youth, Families and Schools
| | - Carolyn Pope Edwards
- University of Nebraska-Lincoln, Departments of Child, Youth and Family Studies and Psychology
| | - Susan M Sheridan
- University of Nebraska-Lincoln, Nebraska Center for Research on Children, Youth, Families and Schools
| | - Kevin A Kupzyk
- University of Nebraska Medical Center, College of Nursing
| | - Christine A Marvin
- University of Nebraska-Lincoln, Department of Special Education and Communication Disorders
| | - Keely D Cline
- East Tennessee State University, Department of Human Development and Learning
| | - Brandy L Clarke
- University of Nebraska-Lincoln, Nebraska Center for Research on Children, Youth, Families and Schools
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Knoche LL, Sheridan SM, Clarke BL, Edwards CP, Marvin CA, Cline KD, Kupzyk KA. GETTING READY: RESULTS OF A RANDOMIZED TRIAL OF A RELATIONSHIP-FOCUSED INTERVENTION ON THE PARENT-INFANT RELATIONSHIP IN RURAL EARLY HEAD START. Infant Ment Health J 2012; 33:439-458. [PMID: 24644374 PMCID: PMC3955711 DOI: 10.1002/imhj.21320] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The purpose of this study is to investigate the effects of a relational intervention (the Getting Ready intervention) on parenting behaviors supporting the parent-infant relationship for families enrolled in Early Head Start home-based programming. Two-hundred thirty-four parents and their children participated in the randomized study, with 42% of parents reporting education of less than a high-school diploma. Brief, semistructured parent-child interaction tasks were videotaped every 4 months over a16-month intervention period. Observational codes of parent-infant relationship behaviors included quality of three parental behaviors: warmth and sensitivity, support for learning, and encouragement of autonomy; two appropriateness indicators: support for learning and guidance/directives; and one amount indicator: constructive behaviors. Parents who participated in the Getting Ready intervention demonstrated higher quality interactions with their children that included enhanced quality of warmth and sensitivity, and support for their children's autonomy than did parents in the control group. They also were more likely to use appropriate directives with their children and more likely to demonstrate appropriate supports for their young children's learning. Results indicate an added value of the Getting Ready intervention for Early Head Start home-based programming for families of infants and toddlers.
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Affiliation(s)
- Lisa L Knoche
- University of Nebraska-Lincoln, Nebraska Center for Research on Children, Youth, Families and Schools
| | - Susan M Sheridan
- University of Nebraska-Lincoln, Nebraska Center for Research on Children, Youth, Families and Schools
| | - Brandy L Clarke
- University of Nebraska-Lincoln, Nebraska Center for Research on Children, Youth, Families and Schools
| | - Carolyn Pope Edwards
- University of Nebraska-Lincoln, Departments of Child, Youth and Family Studies and Psychology
| | - Christine A Marvin
- University of Nebraska-Lincoln, Department of Special Education and Communication Disorders
| | - Keely D Cline
- East Tennessee State University, Department of Human Development and Learning
| | - Kevin A Kupzyk
- University of Nebraska Medical Center, College of Nursing
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Sheridan SM, Knoche LL, Kupzyk KA, Edwards CP, Marvin CA. A randomized trial examining the effects of parent engagement on early language and literacy: the Getting Ready intervention. J Sch Psychol 2011; 49:361-83. [PMID: 21640249 PMCID: PMC3109303 DOI: 10.1016/j.jsp.2011.03.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Revised: 03/12/2011] [Accepted: 03/12/2011] [Indexed: 11/26/2022]
Abstract
Language and literacy skills established during early childhood are critical for later school success. Parental engagement with children has been linked to a number of adaptive characteristics in preschoolers including language and literacy development, and family-school collaboration is an important contributor to school readiness. This study reports the results of a randomized trial of a parent engagement intervention designed to facilitate school readiness among disadvantaged preschool children, with a particular focus on language and literacy development. Participants included 217 children, 211 parents, and 29 Head Start teachers in 21 schools. Statistically significant differences in favor of the treatment group were observed between treatment and control participants in the rate of change over 2 academic years on teacher reports of children's language use (d=1.11), reading (d=1.25), and writing skills (d=0.93). Significant intervention effects on children's direct measures of expressive language were identified for a subgroup of cases where there were concerns about a child's development upon entry into preschool. Additionally, other child and family moderators revealed specific variables that influenced the treatment's effects.
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Affiliation(s)
- Susan M Sheridan
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Nebraska, USA.
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