Clinical Nursing Research current issue

Puerto Rican Women's Perceptions of Heart Disease Risk

Thu, 08 Oct 2009 13:41:38 PDT

Women frequently fail to recognize that coronary heart disease (CHD), not breast cancer, is the primary cause of female mortality. CHD mortality among U.S. mainland Puerto Rican (PR) women is second only to African American women. It is unknown what PR women understand about their risk, what factors they believe contribute to CHD, or whether they know the atypical symptoms often experienced by women. Most CHD studies exclude Hispanic women. Those that do often aggregate their results, making subgroup variations invisible. This study explored awareness of CHD symptoms, risks, and help-seeking behaviors among 12 PR women. Focus group methodology revealed that participants were unaware of their risk and had misconceptions about CHD symptoms and contributing factors. Barriers to early recognition and treatment included lack of knowledge, gender role conflict (caregiver vs. care recipient), and fears of falsely alarming family members or the embarrassment of feeling "dismissed" by health care providers.

Patient Demographics and Learning Needs: Examination of Relationship

Fredericks, S., Guruge, S., Sidani, S., Wan, T. — Thu, 08 Oct 2009 13:41:38 PDT

Background: Limited research has examined differences in patients’ learning needs in relation to demographic characteristics, such as age, gender, level of education, and culture. Yet such knowledge is essential to develop postoperative educational interventions that are tailored to patients’ needs. Study purpose: The purpose of this study was to examine the relationship between learning needs and the demographic characteristics of patients who have undergone coronary artery bypass graft (CABG) surgery. Method: A descriptive design was used.The sample of convenience included 38 patients who met eligibility criteria. Major results: Statistically significant relationships were found between the patients’ age, gender, and cultural background, and learning needs (p < .05) and not between the learning needs and level of education. Application: These preliminary highlight the importance of attending to learning needs of patients with different backgrounds in order to improve self-management following CABG surgery.

Women and Their Partners' Perceptions of the Key Roles of the Labor and Delivery Nurse

Thu, 08 Oct 2009 13:41:38 PDT

This descriptive qualitative study examined the perspectives of women and their partners regarding the key roles of the labor and delivery nurse during labor and birth.Ten couples were interviewed separately.The data analysis, conducted through independent and team analysis, was both iterative and interpretive. Participants identified four key roles of the labor and delivery nurse: support person, educator, patient advocate, and provider of continuity. Nurses provided both physical and emotional support.As an educator, they normalized the birth experience and served as a coach for the couple. Nurses advocated on behalf of the woman in labor, particularly when there was an adverse event. The continuity of care provided by the nurses wove the above roles into a cohesive whole. Findings provide important information for nursing educators, supervisors, and hospital administrators to reinforce the meaningful roles nurses serve in the labor and birth experiences of women and their partners.

Behavioral Indicators of Postoperative Pain in Older Adults With Delirium

Decker, S. A. — Thu, 08 Oct 2009 13:41:38 PDT

The undertreatment of postoperative pain in older adults with delirium is attributed, in part, to the inability to complete self-report pain assessment instruments. Patients’ loss of verbal skills to self-report pain and the lack of reliable and valid postoperative pain assessment instruments for use in older adults with delirium prompted the design of a study to identify common and subtle behavioral indicators of pain. Sixteen experienced registered nurses participating in four focus groups identified behavioral indicators of pain.Transcript analysis resulted in 89 behaviors indicative of pain. Seven researchers with expertise in pain and cognitive impairment in older adults reached 80% agreement on 22 behavioral indicators. The behavioral indicators were classified within one of four pain behavior categories (nonverbal cues/behaviors, vocalizations, facial expressions, and change in usual behavior), and each behavioral indicator was identified as common or subtle. Findings provide evidence of content validity for the pain behaviors.

Research Participation Among Older Adults With Mobility Limitation

Schlenk, E. A., Ross, D., Stilley, C. S., Dunbar-Jacob, J., Olshansky, E. — Thu, 08 Oct 2009 13:41:38 PDT

The purpose of this qualitative descriptive study was to examine reasons for participation in clinical research among older adults with mobility limitation. A purposive sample of 20 men and 20 women aged 70 years or older was recruited. Data were collected by audiotaped telephone interviews using a semistructured interview guide and transcribed verbatim. Participants expect privacy, professionalism by research staff, and respectful treatment. Benefits to protocol adherence include personal education, comparison of their health status with that of others, opportunity to maintain vitality, and altruism. Barriers to protocol adherence are apprehension, in particular a negative impact on their health care, randomization to the control group, and experimental drugs; and inconvenience. Factors promoting study completion are obligation, reciprocity, receipt of test results, health promotion, and socialization. Implications include meeting expectations, providing health education and study results to participants, reducing barriers to participation, and presenting opportunities for interaction with others.