Nurse and patient

Metabolic syndrome is a constellation of risk factors that are precursors to
diabetes and cardiovascular disease. More women than men are diagnosed with metabolic
syndrome. Emphasis on diagnosis of pre-diabetes has resulted in further interest in
metabolic syndrome and the need for weight reduction. Advanced practice nurses care for
women with overweight and obesity in the primary care setting; however there is a lack
of evidence to support the effectiveness of nursing interventions to assist women with
metabolic syndrome lose weight.
Based on Orem's Self-Care Deficit Nursing Theory, this study investigated the
use of a specific supportive-educative nursing intervention to assist individuals make
healthy lifestyle choices to reduce body weight. A pre-test post-test, two group
experimental design was used. It was hypothesized that women given individualized support, education, and guidance about lifestyle modification, which included
carbohydrate counting, would lose more weight and have greater self-care ability than
women given general support and education.
The sample included 51 pre-menopausal women between ages 19 and 55 who had
been diagnosed with metabolic syndrome. Body weight and perceived self-care, using the
Self-as-Carer inventory, were measured at the onset of the study and again three months
later. The two groups did not differ significantly as to weight or perceived self-care at
baseline or at conclusion of the study. A repeated measures analysis of variance for
weight loss and perception of self care was calculated and the results indicated that there
was no significant difference in weight loss (p=.13) or perception of self care (p=.85)
between the two groups.
The use of a supportive-educative individualized nursing intervention enhanced
participant awareness of healthy lifestyle choices. Further research is needed to determine
the effectiveness of the intervention with a larger, more ethnically diverse sample and
with participants diagnosed with other metabolic disorders.

The purpose of this study was to describe the lived experience of nurses who care for hospitalized women outside of an addiction treatment setting who have a problem with drugs and/or alcohol. The relational experiences of ten registered nurses who had cared for women with drug and alcohol problems were elicited. Heideggerian hermeneutic phenomenology was the method used to interpret the nurse participant's meaning of their experience. The theoretical framework that was used to explore the nurses' experience o caring for women who abuse or are dependent on alcohol and/or drugs was Boykin and Schoenhofer's Nursing as Caring (1993). The relational themes that emerged were: Caring in the dark; Intentionally knowing the woman with AOD as a unique person; and Experiencing sisterhood.

Nursing care is considered a primary predictor of patient assessment of the overall
hospital experience. Yet, quality nursing care remains difficult to define. Limited
research about nurse or patient perspectives on what constitutes quality nursing care in
hospital settings prevents the identification of a shared description or insight into their
possible interrelationship. Research about nurse and patient descriptions is needed to
establish behaviors, attributes, and activities associated with quality nursing care to
improve the health and well-being of hospitalized patients.

The purpose of this study was to investigate the process used by Haitians and Haitian Americans who must make healthcare decisions for a terminally ill family member. There is a large population of Haitians and Haitian Americans in South Florida and there has been no research regarding their decision-making process about end-of-life healthcare. The study design was descriptive, applying constructivist grounded theory methodology. Data were collected using semi-structured, face-to-face qualitative interviews. Data analysis and collection occurred simultaneously. Participants (n=12) were purposefully recruited, with 11 from a single, faith-based community. The findings resulted in six concepts: (1) imminent or actual death, (2) disrupted unity, (3) managing disrupted unity, (4) consequences, (5) restoring unity, and (6) creating memories you can live with. These six concepts, elaborated by an additional 17 dimensions, were incorporated into a process model relating to the cultural value of communal unity to the end-of-life decision-making process. The implications of this study include a need to improve the congruence between the nursing care provided at this vulnerable time and the cultural values of this population. Successful access to this population through the structure of the faith-based community points the way to increasing access to appropriate end-of-life healthcare. Practice implications informed by caring science include the importance of nurses’ coming to know the family and listening to the unique care needs.

With passage of the Patient Protection and Affordable Care Act (PPACA) and the
publication of the Institute of Medicine’s report on the future of nursing, nurses are slated to take on an expanded role in primary healthcare delivery in the near future. Nurse practitioners, in particular, will be instrumental in filling the gap in primary care
availability engendered by the increasing specialization of physician practice and
increased access to healthcare made possible by the provisions of the PPACA.
The need for this study was identified through gaps in the literature related to nurse practitioner practice; specifically, the paucity of quantitative research regarding
patients’ perspectives of core holistic nursing values in nurse practitioner care, and, since nursing care is by definition and tradition holistic in nature, this inquiry attempted to quantify the degree to which nurse practitioner care upholds and preserves core holistic nursing values.

Patients who are hospitalized and are without voice would like to participate in
their care. This requires clear communication. Speak for Myself™ (SFM) was developed
for use at the bedside so that communication may be facilitated between patient and nurse when the patient is voiceless. The objective of this study was to evaluate Speak for Myself™ at the bedside and to measure the outcomes. This was a mixed methods, one group pre-test-post-test, quasi-experimental study. Twenty adult patients in three
hospitals in South Florida agreed to use Speak for Myself™ during their acute care
hospital stay (M = 8.86 hours). This group of participants (n = 20) ranged from 45 to 91
years old (males = 14; females = 6). Of the participants, 15 (75%) self-identified as
European American, 2 (10%) self-identified as Hispanic, 2 (10%) self-identified as
African American, and 1 (5%) self-identified as Asian. Ten of the participants (50%)
were in respiratory failure. Two (10%) were receiving oxygenation measures related to
unspecified complications of their illnesses. Of the remaining eight participants (40%),
one each was receiving oxygenation measures due to atrial fibrillation, arteriosclerotic
heart disease, cardiogenic shock, endocarditis, neck abscess, renal failure, status post
seizure activity, and tongue metastasis.

The purpose of this study was to describe the caring behaviors incorporated into the practice of perioperative nursing. Utilizing a descriptive survey design, this study provided 104 perioperative nurse participants who were members of the AORN with the Caring Behaviors Inventory (CBI). Data collected in this study supported the use of the CBI as a reliable instrument for measuring caring behaviors as measured by a Cronbach's alpha coefficient of.9486. The top five caring behaviors that emerged were (1) showing respect; (2) treating patient information confidentially; (3) appreciating the patient as a human being; (4) showing concern; (5) and supporting the patient. The study revealed that perioperative nurses do incorporate caring behaviors into their practice that are both patient-centered and action oriented. These behaviors are similar to those previously described by nurses in other specialties. Implications for nurse education and practice are presented, as are recommendations for further research.

The purpose of this phenomenological-hermeneutic study was to increase understanding of the caring experiences of the contemporary nurse executive practicing in four different types of health care systems. Nurse executives were asked to address the meaning of caring to them as a nurse executive. Five descriptive themes emerged from the participants: seeing things from a global perspective, advocating for the patient, providing an environment supportive of professional patient care, participating in the integration of services, and promoting a shared governance with the staff nurse or front line provider. An overall Interrelational Model of Health Care Delivery, derived from complexity science and chaos theory emerged from these descriptive themes.

This study is a pilot concerning the relationship between acute pain management and biofeedback training. The population studied included patients from a local community hospital undergoing coronary artery bypass graft surgery. The study applied theories of the mind/body connection and stress frameworks for exploring the correlation between patients' hand temperatures and their reported levels of pain pre-operatively and post-operatively. Study findings indicated that there was significant within-subjects effect in hand temperature after biofeedback treatment across three points in time. But the study also found no difference between-subjects in hand temperature after biofeedback treatment across three points in time. Therefore, the sample proved to be heterogeneous. Further study was indicated with larger samples to demonstrate the analgesic effects of biofeedback in the management of acute pain.

The purpose of the study was to test experimentally the effectiveness of a presurgical teaching intervention on reducing the anxiety of children undergoing outpatient surgery and in facilitating the children's emotional adjustment during the postsurgical period. The efficacy of a child teaching session combined with a parent teaching session was compared with the efficacy of a parent only session. The participants of the study were 33 children, ages 4 to 12, and their parents. Two weeks following the child's surgery, the parents assessed the child's postsurgical adjustment by completing the Post Hospital Behavior Questionnaire (PHBQ). Data was analyzed by t-test using.05 as the significance level. Results of the t-test showed no significant difference between the experimental and the control groups (t = 1.910, df = 27, p =.067). However, both groups showed behavioral upset on the PHBQ following surgery (control group = 87.75, experimental group = 84.46). This increased behavioral upset suggests that surgery is anxiety producing in children. The trend toward lower scores in the experimental group indicated less behavior upset and therefore less anxiety for the children receiving the teaching intervention.