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May 1999 - Volume 5, Number 3
Return to Top Dunbar-Jacob was appointed to her new position after a two-year search for a
chairperson. Dr Ann Yurick, who retired in 1999, served as department chair for Health and
Community Systems for 7 years. Congratulations to Dr. Willa Doswell Return to Top Issues from the Center for the Advancement of Health Excerpted from Center for the Advancement of Health newsletter, "Health and Behavior Information Transfer (HABIT), April 20, 1999, 2 (6) Return to Top
Return to Top CRCD Investigators Present in Honolulu Dr. Kathy Lucke, Dr. Patricia Bohachick, and Dr. Ann Mitchell were invited to presented findings of their research at the Clinical Research and Managed Care Environment Conference for Nurse Researchers, held March 19-20, 1999 in Honolulu, Hawaii. The following is abstracted from each of their presentations. Dr. Kathy Lucke presented, "Spinal Cord Injury Rehabilitation: Gaps in Care Since Managed Care." She found there is little systematic research to guide the health care providers on the early recovery process following Spinal Cord Injury (SCI) and interventions that are linked with successful rehabilitation outcomes. Nearly 10,000 spinal cord injuries (SCI) occur annually, resulting in devastating consequences and costs approaching $1.5 million over the lifetime of the SCI individual. A constant comparative method, using semi-structured in-depth tape recorded interviews, was combined with descriptive quantitative methods using the Medical Outcomes Study SF-36 as a measure of health-related QOL and horizontal visual analog scales (h-VAS) for measuring pain and QOL. Data were collected from adults with traumatic SCI and their informal caregivers at 1, 3, and 6 months after discharge from rehabilitation centers in southwestern Pennsylvania. Due to shortened length of stay and limited readmissions to rehabilitation resulting from managed care, SCI individuals have less time to acquire requisite knowledge and have limited exposure to individuals with a previous SCI from which to learn practical skills. Health care professionals, especially nurses, can utilize this opportunity to develop creative and innovative strategies with SCI individuals to maintain hope, facilitate knowledge acquisition and decision making, continue the process of reintegration, and enhance QOL for SCI individuals and their caregivers following rehabilitation. Dr. Patricia Bohachick presented, "Sense of Personal Control and Quality of Life in Rheumatoid Arthritis." The purpose of the study was to determine the relationship between psychosocial resources, operationalized as perceived social support, and quality of life in rheumatoid arthritis (RA). A conceptual model for the study was adapted from an extension of the life stress and illness vulnerability models. In the model, quality of life in chronic illness is conceptualized as a multidimensional construct that includes the common deleterious life quality consequences of chronic illness including symptom severity, functional impairment, and psychological distress. Quality of life in the chronically ill is proposed to be further compromised by inadequate psychosocial resources. Findings of her study were consistent with other evidence suggesting that social support is an important psychosocial resource for psychological and physical adaptation to chronic illness. The lack of an association between duration of RA and perceived social support was of interest in view of the concern that the longer the length of illness, the less social support one is likely to receive. She said further study is being undertaken to determine the causal direction of the relationship among variables in the present study and the types of support important to adaptation to RA. Clarification of the role of social support to the adaptation to RA can provide a basis for the design and testing of support interventions to improve well being of patients with RA. Dr. Ann Mitchell presented, "Evaluation of Critical Incident Stress Debriefing (CISD) for Survivors of Suicide." For these 224,000-320,000 survivors, the death by suicide is a critical incident that is often associated with changes in functional ability through the associated affective, behavioral, and cognitive responses. These include: psychological problems, post traumatic stress disorders (PTSD), changes in quality of life and social adjustment, and at times, physical illness or even death. Therefore, sudden, unnatural deaths by suicide pose a significant public health concern. Critical incident stress debriefing (CISD), is a stress management intervention grounded in crisis intervention and educational theory. It has been shown to be effective in lowering stress symptoms in police, firefighters, EMS personnel, and the military. It is an intervention that is widely used to mitigate the impact of a critical incident, accelerate the return of the person's routine functioning after the critical incident, and prevent PTSD. Because the suicide of a family member or a significant other is a critical event in the life of the survivors, in that the death is sudden, unnatural, and often associated with negative stigma, CISD may be a valuable intervention in this situation. Therefore, the purpose of her study is to evaluate the use of the CISD intervention as developed by the International Critical Incident Stress Foundation, for survivors of suicide. The study is a randomized, experimental, 2 x 4 longitudinal design that will evaluate the effectiveness of a CISD intervention during the early bereavement (up to one month) on the functional ability of the survivors of suicide as measured by their affective, behavioral, and cognitive responses, and determine whether the type of coping strategies used by the survivors influences the effect of the CISD intervention on their functional ability. Data are being collected by self-report questionnaires. The reliability and validity of the standardized instruments used in the study are well know and documented. Preliminary results of her study were presented. She said the results provide information about the efficacy of an immediate CISD intervention on survivors of suicide. Dr. Daniel Morrow Reports on Impact of Communication on Adherence by Kristine Keefer Wolff, BSN, RN Return to Top Dr. Morrow used a client-centered framework that utilizes comprehension and other
processes to study the accomplishment of health tasks. He also studied the interaction of
aging and communication, and the effects of utilizing a health message design to impact
the client’s adherence. He reported that increasing age was associated with decreases
in working memory and that altered processing speed may impair attention (distraction),
comprehension (integration), planning (reasoning), and prospective memory (time
monitoring). He also reported that knowledge only benefits older adults if communication
supports knowledge use and that the use of written and verbal message designs can help
clients achieve a higher adherence rate. Written instructions and automated verbal
appointment message designs were two tools that were shown to be beneficial with adherence
rates in this study. He found that written messages with icons achieved higher adherence
rates and that the instructions were less dependent on the client’s literacy. Written
messages should be in listed form with appropriate paragraph breaks
to separate information. Dr. Morrow shared that automated verbal appointment messages left
on clients’ answering machines yielded higher adherence rates. He also indicated that
when this practice is repeated, an even better adherence rate was found. A videotape of
Dr. Morrow's lecture is available to view by calling Stephanine Duplaga at 412-624-7838. Dr. Jan Atwood Lectures on Cancer Prevention Research by Donna Caruthers, MSN, PhC Return to Top Dr. Atwood gave a 2-part presentation that integrated genetic and biological data with community based cancer prevention research. Initially, she provided an overview of a community based cancer prevention research project known as the P.R.A.I.S.E. project, which used African American churches to disseminate dietary information and an intervention aimed at decreasing the risk of colon cancer among congregation members. For the second part of her presentation, Dr. Atwood focused on the development of biopsychosocial markers of behavior change. In addition to an overview of literature findings on this topic, Dr. Atwood provided methods and results related to her work in the development of a biological marker for dietary adherence to increased fiber consumption to prevent colon cancer. Both parts of Dr. Atwood's presentation were informative with regard to research methods, intervention adherence, and monitoring. For those researchers interested in cancer prevention, adherence, and biopsychosocial markers, Dr. Atwood's presentation is available for review from the CRCD videotape library, by calling 412-624-7838.Dr. Morisky Discusses Strategies for High Blood Pressure Control by Elizabeth Schlenk, PhD, RN Return to Top New Books and Publications in CRCD Library Return to Top Evaluating nursing interventions – S. Sidani & C. J. Braden (1998) Return to Top
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Copyright 2000 © University of Pittsburgh, School of
Nursing, Center for Research in Chronic Disease. All Rights Reserved. The materials
presented at this site are for reference only. Information may not be reproduced
without permission from the CRCD. |
On May 1, 1999, Jackie Dunbar-Jacob, PhD, RN, FAAN
began her new position as chairperson of the department of Health and Community Systems in
the School of Nursing. She will also maintain her position as director of the CRCD and
professor of nursing and epidemiology.