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Publication Complementary therapy and care to relieve pediatric cancer therapy-related symptoms in Thailand(2011-09-08) Shanberg, Rachel; Williams, Phoebe D.; Piamjariyakul, UbolratPatients undergoing treatment for cancer, whether it includes chemotherapy and/or radiation, experience many side effects that are linked to the treatment. The specific purposes of this study were to examine (a) what Thai parents report they do to help alleviate symptoms that the child experiences during cancer therapy; and (b) what categories of dependent care and/or complementary therapies were those methods reported. Orem’s self-care/dependent-care concept was used to guide the analysis of the care pediatric patients received. Secondary analysis was done of data collected from a larger study at the National Children’s Hospital in Thailand. The sample included children ages 5-17 years (N=100). Of the 100 patients, 71 were male and 29 female; while 75 patients were 5-11 years old, and 25 patients 12-17 years old. Cancer diagnoses can be divided into the following: 63% leukemia, 12% nervous system tumors, 10% solid tumors, 6% lymphoma, and 9% Other. The 34-item Therapy-Related Symptom Checklist for Children (TRSC-C) was used to record patients’ symptom occurrence/severity (0, no symptom; 4, “A whole lot”); and the Symptom Alleviation: Self-Care Methods (SA:SCM) tool was used to identify methods parents used to alleviate chemotherapy-related symptoms. To address the study purposes, descriptive data and content analyses were done. Symptom occurrence of 16 symptoms were reported by 45% or more of patients; and mean severity “2”, or “Quite a bit” of the top five reported symptoms included hair loss, nausea, vomiting, fever, loss of appetite. Of the six categories of self/dependent-care methods/complementary therapies, all were found useful; and, Diet/nutrition/life-style and Mind/Body Control were the most utilized. Assessing patient/parent-reported symptoms and use of self/dependent care and complementary therapies help Thai families cope during pediatric cancer treatments.Publication Family caregiver strain and resident distress in the dementia population of nursing home facilities(2011-09-08) Harris, Brynn; Bott, Marjorie J.End-of-life care in the U.S. is increasingly provided in nursing homes (NHs), and over half of all NH residents have some degree of cognitive impairment. Given the prevalence of this cognitive decline, there is a surprising gap in research related to the management of distress in this patient population and their family caregivers. Symptoms of distress vary based on multiple factors (e.g., pain, cognitive status, type of caregiver) and can be masked in the cognitively impaired due to communication difficulties. The purpose of this study was to examine whether resident and family caregiver distress and strain are different among three NH resident groups based on diagnoses: (a) Alzheimer’s, (b) other dementia disorders, and (c) non-cognitive diagnoses. This exploratory study was a secondary analysis of data collected from a longitudinal study examining end-of-life care in NHs. The sample was comprised of 1,282 pairs of NH residents and their family caregivers from two Midwestern states. Caregiver and resident distress and strain were measured with the Caregiver Strain Index and the Family Memorial Symptom Assessment Scale Global Index, respectively. ANOVA procedures were used to test for differences among the groups, and follow-up tests were conducted using Duncan/Dunnett’s T3 tests. Findings indicated significant decreases in distress (F(2,1267) = 34.16, p<.001) and strain (F(2,1267) = 10.08, p<.001) among cognitively-impaired residents from those who were cognitively intact. No significant differences were found in caregiver distress or strain based on the cognitive status of their loved one. It is uncertain whether the reported differences are attributable to communication difficulties of the cognitively-impaired residents or whether they are experiencing less distress and strain. Research in other geographic locations using larger samples are needed to provide further insight.Publication Exploring barriers to exclusive breastfeeding among adolescent Latina women(2011-09-08) Hansen, Lauren Louise; Wambach, KarenAmerican adolescent mothers typically have low rates of exclusive breastfeeding. Currently, Hispanics make up the largest ethnic group in the U.S., have high fertility rates, bear their children at younger ages, and also have low rates of exclusive breastfeeding. These factors put adolescent Latina mothers at higher risk for not exclusively breastfeeding; however, there is a lack of research about exclusive breastfeeding in this population. This study examines the attitudes and barriers to exclusive breastfeeding in a sub-sample of adolescent Latinas who are part of an ongoing larger qualitative exploration of barriers to exclusive breastfeeding. Pender’s health promotion model frames the study in which enrollment is currently taking place in a large city in the Midwest. An exploratory descriptive approach is being performed using semi-structured, in-person interviews conducted in either English or Spanish with the use of the ARSMA-II to identify participants’ acculturation levels. Tape-recorded interviews are transcribed verbatim. Spanish transcripts are translated to English for analysis. Inductive content analysis is being performed by hand. For this sub-study, the results are then interpreted in relation to Pender’s Health Promotion Model in a case analysis fashion. One 16 and one 17-year-old mother comprised this case analysis. Acculturation scores suggest that the younger teen is more acculturated than the older teen. Findings were consistent with concepts of Pender’s model. The largest difference between the two cases was the amount of school support each received, with one teen getting ample support while lack of support hindered the other in providing breast milk. Findings are consistent with previous adolescent breastfeeding research regarding support.Publication Building student resources for the Kansas Center for Nursing Scholarship and Leadership(2011-09-08) Feighny, Michael; Teel, CynthiaThe Kansas Center for Nursing Scholarship & Leadership (KCNSL) was recently created with the purpose of advancing nursing scholarship in Kansas through focused mentorship and broad-based collaboration. The Center is developing resources for nursing students, and stress management was identified as an area of need. High stress is common in nursing students and may negatively affect student success. The purpose of the study was to identify and describe sources of student stress and stress management strategies among nursing students. Senior nursing students from 13 pre-licensure baccalaureate nursing programs in Kansas were invited to participate in semi-structured interviews. A qualitative descriptive approach was used to describe the experience of student stress and strategies for stress management. Sources of stress among participants (n=2) included concern about studying for exams, balancing competing time commitments, and meeting deadlines. Stress management strategies included taking breaks, exercising, playing video games, smoking, and spending time with friends. Findings related to the stress experience and suggestions for stress management will be displayed on the KCNSL website as a resource for other nursing students.Publication Patient satisfaction for the adults with Down Syndrome Specialty Clinic(2011-09-08) Bowman, Samantha; Peterson, MoyaThe Adults with Down Syndrome Specialty Clinic (ADSSC) was established in 2008 to better meet the unique needs of adults with Down syndrome due to many concerns regarding the health care that patients with Down syndrome receive. The purpose of this study was to assess the quality of care that the patients and families receive at this clinic and determine any additional resources that need to be incorporated into the patients’ care. A satisfaction survey was developed and mailed to all of the patients (N=75) and 24 responses were obtained. The Likert scale questions were analyzed using weighted calculations and the written narrative responses were reviewed. There were six categories that were analyzed which include: ease of getting care, waiting, provider, nursing staff, all other staff, and facility. Overall, the patients were satisfied with the care that they are receiving at the ADSSC. However, two main concerns for the patients were better location of the facility and better parking. Many of these adults face difficulty finding services that can meet their individual needs. As a result of this study we hope to provide more access to resources as well as high quality healthcare to this population.Publication Self reported health promotion behaviors of individuals with psychiatric disabilities in a weight loss intervention(2011-09-08) Biethman, ElyseIntroduction: Research shows that individuals with psychiatric disabilities, particularly those with schizophrenia, die on average 25 years earlier than the general population (Marder et al., 2004). Excess mortality is due primarily to cardiovascular disease but also from other comorbid conditions exacerbated by obesity. Limited income in combination with poor diet, lack of exercise, and psychiatric medications often contribute to obesity in individuals with psychiatric disabilities. Purpose: this study examines if individuals in a weight loss program report an increase in healthy eating and physical activity over time compared to those in a control group. Methods: scores from two subscales of the Health-Promoting Lifestyle Profile II (HPLPII) were administered at baseline, 3 months, 6 months and 12 months to individuals who were randomly assigned to a Psychiatric Rehabilitation Approach to Weight Loss program or a control group. Scores were analyzed using a repeated measure ANOVA. Findings: change in self-report of nutrition between the control and intervention groups did not significantly change over the course of the study. However, change in self-report of physical activity between the intervention and the control group was significant, with significant changes between baseline and three months, baseline and six months, but not between baseline and twelve months. Discussion: Participants in the Psychiatric Rehabilitation Approach to Weight Loss program reported increased physical activity, but reported no changes in nutrition compared to the control group. Further study is needed to determine if self-report of increased physical activity is confirmed with actual increase in activity.Publication The Journal of BSN Honors Research, Volume 4, Issue 1, Summer 2011(2011-09-08) Biethman, Elyse; Bowman, Samantha; Feighny, Michael; Hansen, Lauren Louise; Harris, Brynn; Shanberg, Rachel