- Email: [email protected]
Improving Global Health - NY to China
2009 AAN Poster Abstracts continued From the AAN Annual Meeting and Conference
Purpose: (1) To determine if there were differences in the frequency of utilization and the dosages of analgesia self-administered through patient-controlled analgesia (PCA) for the first 24 hours following Cesarean birth by African American, Hispanic, and White women; and (2) to determine whether there were differences in the types of analgesic medications prescribed postPCA for women in the three groups. Methodology: Following IRB approval, a stratified random sample of 114 medical records (43 AfricanAmerican, 35 White, and 36 Hispanic) of women meeting study inclusion criteria (C-Section patients treated with morphine via PCA for up to 24 hours post delivery) were reviewed. Data collected included demographic information, type of anesthesia used, amount of morphine/ hr administered, number of PCA attempts made/hr, number of hours PCA used, and pre and post operative complications. Findings: There were no significant differences between the groups in the number of attempts/hr while using the PCA (p¼26) or the dose of morphine received per hour (p¼97). These differences persisted when controlling for age, gravidity, and complications. There also were no differences between the groups in the types of medication ordered (narcotic vs non-narcotic) following discontinuation of the PCA (p¼51). Summary Concluding Statement: This study found no difference in the amount of analgesia received, the attempts made to receive analgesic medications via PCA, or analgesia prescription post-PCA among C-Section patients of three racial groups. The study indicates that, post-Cesarean, African-Americans, Whites, and Hispanics desire similar amounts of analgesia.
Collaborating for Healthy Women of Low SES Diane Lauver, PhD, RN, FNP-BC, FAAN, Denise E. Contreras, BS, RN, and Ernise Williams, BS, MS, RN
Background: Women of low SES (socioeconomic status) are more likely to: have chronic stress, be sedentary, and experience chronic diseases, yet lack health care. As such, they are especially in need of health promotion services and comprise a vulnerable and underserved population. Collaboration between schools of nursing and community groups can create patient-centered and culturally sensitive interventions to promote health behaviors among low SES women. Purpose: To share collaborative processes between a school of nursing and community groups for the development and delivery of health promotion services to low SES women. Methodology: Using community-based participatory approaches with descriptive qualitative designs, faculty and staff met with leaders and clients of three commu-
nity groups serving women of low SES, especially homeless, African-American and Latina women Faculty and staff assessed the acceptability of the focus, mode, and setting for a possible patient-centered, nurse-facilitated health promotion program. The program was based on prior health promotion research and complementary theories for initiation and maintenance of health behaviors. Community group leaders and clients provided formative evaluations in group sessions. Content analyses were conducted on responses. Findings: Informants welcomed a health promotion program, supporting foci on stress management, activity and diet, suggesting additional content on violence, and sharing ways for nurses to be culturally acceptable in their approach. Informants endorsed having group sessions for building knowledge and skills along with individual coaching for supporting behavior change. They wanted the programs held in their community centers. Research funds were procured to evaluate the program using a one-group pre- post-intervention design. Summary Concluding Statement: Collaboration between a school of nursing and community groups resulted in partnerships to offer patient-centered, culturally sensitive health promotion for women of low SES in different community settings. Implementation and evaluation of the program are ongoing.
Improving Global Health - NY to China Kathleen Leask Capitulo, DNSc, RN, FAAN
Background: This presentation will focus on a global nursing leadership project, connecting nursing leaders in New York with nursing leaders in Wenzhou China. As a Robert Wood Johnson Executive Nurse Fellow, I designed a projected with the Dreyfus Health Foundation, creating a Transcultural Nursing Leadership Institute (TNLI). The program is unique in that it gives a practical framework to local health leaders to identify problems of relevance to them, within their own culture and health system, enabling them to create projects with evidencedbased interventions and measurable outcomes to address the problems. Projects are identified and owned by the local health leaders, who are responsible for carrying out the projects. Purpose: The purpose of the TNLI is to promote scholarly and professional collaboration between nurse leaders in the United States and international nursing leaders to improve health to vulnerable populations. Methodology: The TCNLI utilized a successful methodology for health care change, Problem Solving for Better Health (PSBH)â, developed by the Dreyfus Health Foundation. Nurses in Wenzhou, China were empowered to lead evidenced based change projects to make major improvements in health within their areas of practice. M
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2009 AAN Poster Abstracts continued From the AAN Annual Meeting and Conference
Findings: The Wenzhou PSBH(r) projects ranged from improving health education to migrant worker adolescents to HIV education to factory workers. The TCNLI built bridges with hospital leadership in China facilitating the success and sustainability of the projects. The presentation will focus on transcultural partnerships, global collaboration, resulting joint research, publications, and international teamwork. Lessons learned from global collaboration will be discussed as well as creating system for sustainability, with more than 200 health care professionals in China participating in the Institute’s work, attending the PSBHâ workshop and leading change projects throughout the province of more than 43 million people. Summary Concluding Statement: Through partnership, collaboration, and sharing, the TCNLI and its participants are truly making a difference Nurses are truly changing the world!
appropriately plan for parental support and bereavement rituals for Hispanic patients and test models for interventions designed to assist bereaved families. Professionals caring for perinatal patients should be aware of the cultural implications for caring for the bereaved, including appropriate rituals and support. Implications for practice, education and research will be discussed. Summary Concluding Statement: The care of bereaved parents is framed in culture Research of this vulnerable population is key to evidenced based improvements in care. This new psychometrically sound instrument, the SpSVPGS, enables researchers to compare the dimensions and attributes of grief, interventions, and rituals in Spanish speaking bereaved parents.
Ethnic Differences in Physical Activity of Women Bokim Lee, PhD, MPH, RN, Seunghee Lee, PhD, MPH, RN, Wonshik Chee, PhD, and Eun-Ok Im, PhD, MPH, RN, CNS, FAAN
Perinatal Grief in Spanish Speaking Families-Psychometric Testing of the New Spanish Version of the Perinatal Grief Scale
Background: Most of the previous studies on physical activity have focused on identifying the factors associated with physical activity, but ethnicity as a predictor influencing physical activity has rarely been considered in these studies. Purpose: The purpose of this study was to explore ethnic differences in physical activity reported by four ethnic groups (White, Hispanics, Asian, and African) of midlife women in the US and to compare factors associated with physical activity in each of the ethnic groups. Methodology: This study was conducted as part of a larger internet study on menopausal symptoms of diverse ethnic groups of midlife women. A total of 512 research participants (160 Whites, 120 Hispanics, 121 African, and 111 Asians) were recruited using multiple strategies through Internet settings. Findings: There was a statistically significant ethnic difference in hours for total physical activity time and hours for leisure. Whites had significantly more hours of total physical activity and hours of leisure activity per week than did other ethnic groups. According to the stepwise multiple regression analyses, being White was a statistically significant predictor of more hours of total physical activity after adjusting for confounding variables. Usual activity level and social support were significant predictors of hours of physical activity in the White group. Employment status, income level, and social support were significant predictors of hours of physical activity in the Hispanic group. Age was a significant predictor of hours of physical activity in the African group. Country of birth was a significant predictor of hours of physical activity in the Asian group.
Kathleen Leask Capitulo, DNSc, RN, FAAN, Marjorie Ramirez, MA, EdM, RN, Betina GrigoroffAponte, BS, IBCLC, and Doris Vahey, PhD, RN
Background: Bereaved parents are among the most vulnerable populations in Maternal-Child Health. However, research in perinatal bereavement has been limited to white, non Hispanic populations. Purpose: The purpose of this study was to scientifically translate a research instrument to measure perinatal grief in Spanish speaking parents and to psychometrically test the instrument to accrue evidence for reliability and validity. Methodology: The authors used translation/backtranslation, focus groups, and expert translation to develop the new Spanish Short Version of the Perinatal Grief Scale (SpSVPGS). The instrument was administered to convenience samples 50 bereaved Spanish speaking parents and a control group of 40 Spanish speaking non-bereaved parents. Findings: Content validity and reliability for the new instrument were established. In this study, most Spanish speaking parents participated in bereavement rituals, including seeing, holding, touching, naming, and having funerals, for their deceased child. The data showed a 29% decrease in the percent of parents married at the time of the loss and the time of the study. Findings may enable clinicians to better meet the bereavement needs of Spanish speaking parents experiencing perinatal losses. Analysis of demographic information, including marital status and rituals, may enable clinicians to e16
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Purpose: (1) To determine if there were differences in the frequency of utilization and the dosages of analgesia self-administered through patient-controlled analgesia (PCA) for the first 24 hours following Cesarean birth by African American, Hispanic, and White women; and (2) to determine whether there were differences in the types of analgesic medications prescribed postPCA for women in the three groups. Methodology: Following IRB approval, a stratified random sample of 114 medical records (43 AfricanAmerican, 35 White, and 36 Hispanic) of women meeting study inclusion criteria (C-Section patients treated with morphine via PCA for up to 24 hours post delivery) were reviewed. Data collected included demographic information, type of anesthesia used, amount of morphine/ hr administered, number of PCA attempts made/hr, number of hours PCA used, and pre and post operative complications. Findings: There were no significant differences between the groups in the number of attempts/hr while using the PCA (p¼26) or the dose of morphine received per hour (p¼97). These differences persisted when controlling for age, gravidity, and complications. There also were no differences between the groups in the types of medication ordered (narcotic vs non-narcotic) following discontinuation of the PCA (p¼51). Summary Concluding Statement: This study found no difference in the amount of analgesia received, the attempts made to receive analgesic medications via PCA, or analgesia prescription post-PCA among C-Section patients of three racial groups. The study indicates that, post-Cesarean, African-Americans, Whites, and Hispanics desire similar amounts of analgesia.
Collaborating for Healthy Women of Low SES Diane Lauver, PhD, RN, FNP-BC, FAAN, Denise E. Contreras, BS, RN, and Ernise Williams, BS, MS, RN
Background: Women of low SES (socioeconomic status) are more likely to: have chronic stress, be sedentary, and experience chronic diseases, yet lack health care. As such, they are especially in need of health promotion services and comprise a vulnerable and underserved population. Collaboration between schools of nursing and community groups can create patient-centered and culturally sensitive interventions to promote health behaviors among low SES women. Purpose: To share collaborative processes between a school of nursing and community groups for the development and delivery of health promotion services to low SES women. Methodology: Using community-based participatory approaches with descriptive qualitative designs, faculty and staff met with leaders and clients of three commu-
nity groups serving women of low SES, especially homeless, African-American and Latina women Faculty and staff assessed the acceptability of the focus, mode, and setting for a possible patient-centered, nurse-facilitated health promotion program. The program was based on prior health promotion research and complementary theories for initiation and maintenance of health behaviors. Community group leaders and clients provided formative evaluations in group sessions. Content analyses were conducted on responses. Findings: Informants welcomed a health promotion program, supporting foci on stress management, activity and diet, suggesting additional content on violence, and sharing ways for nurses to be culturally acceptable in their approach. Informants endorsed having group sessions for building knowledge and skills along with individual coaching for supporting behavior change. They wanted the programs held in their community centers. Research funds were procured to evaluate the program using a one-group pre- post-intervention design. Summary Concluding Statement: Collaboration between a school of nursing and community groups resulted in partnerships to offer patient-centered, culturally sensitive health promotion for women of low SES in different community settings. Implementation and evaluation of the program are ongoing.
Improving Global Health - NY to China Kathleen Leask Capitulo, DNSc, RN, FAAN
Background: This presentation will focus on a global nursing leadership project, connecting nursing leaders in New York with nursing leaders in Wenzhou China. As a Robert Wood Johnson Executive Nurse Fellow, I designed a projected with the Dreyfus Health Foundation, creating a Transcultural Nursing Leadership Institute (TNLI). The program is unique in that it gives a practical framework to local health leaders to identify problems of relevance to them, within their own culture and health system, enabling them to create projects with evidencedbased interventions and measurable outcomes to address the problems. Projects are identified and owned by the local health leaders, who are responsible for carrying out the projects. Purpose: The purpose of the TNLI is to promote scholarly and professional collaboration between nurse leaders in the United States and international nursing leaders to improve health to vulnerable populations. Methodology: The TCNLI utilized a successful methodology for health care change, Problem Solving for Better Health (PSBH)â, developed by the Dreyfus Health Foundation. Nurses in Wenzhou, China were empowered to lead evidenced based change projects to make major improvements in health within their areas of practice. M
A R C H
/ A
P R I L
N
U R S I N G
O
U T L O O K
e15
2009 AAN Poster Abstracts continued From the AAN Annual Meeting and Conference
Findings: The Wenzhou PSBH(r) projects ranged from improving health education to migrant worker adolescents to HIV education to factory workers. The TCNLI built bridges with hospital leadership in China facilitating the success and sustainability of the projects. The presentation will focus on transcultural partnerships, global collaboration, resulting joint research, publications, and international teamwork. Lessons learned from global collaboration will be discussed as well as creating system for sustainability, with more than 200 health care professionals in China participating in the Institute’s work, attending the PSBHâ workshop and leading change projects throughout the province of more than 43 million people. Summary Concluding Statement: Through partnership, collaboration, and sharing, the TCNLI and its participants are truly making a difference Nurses are truly changing the world!
appropriately plan for parental support and bereavement rituals for Hispanic patients and test models for interventions designed to assist bereaved families. Professionals caring for perinatal patients should be aware of the cultural implications for caring for the bereaved, including appropriate rituals and support. Implications for practice, education and research will be discussed. Summary Concluding Statement: The care of bereaved parents is framed in culture Research of this vulnerable population is key to evidenced based improvements in care. This new psychometrically sound instrument, the SpSVPGS, enables researchers to compare the dimensions and attributes of grief, interventions, and rituals in Spanish speaking bereaved parents.
Ethnic Differences in Physical Activity of Women Bokim Lee, PhD, MPH, RN, Seunghee Lee, PhD, MPH, RN, Wonshik Chee, PhD, and Eun-Ok Im, PhD, MPH, RN, CNS, FAAN
Perinatal Grief in Spanish Speaking Families-Psychometric Testing of the New Spanish Version of the Perinatal Grief Scale
Background: Most of the previous studies on physical activity have focused on identifying the factors associated with physical activity, but ethnicity as a predictor influencing physical activity has rarely been considered in these studies. Purpose: The purpose of this study was to explore ethnic differences in physical activity reported by four ethnic groups (White, Hispanics, Asian, and African) of midlife women in the US and to compare factors associated with physical activity in each of the ethnic groups. Methodology: This study was conducted as part of a larger internet study on menopausal symptoms of diverse ethnic groups of midlife women. A total of 512 research participants (160 Whites, 120 Hispanics, 121 African, and 111 Asians) were recruited using multiple strategies through Internet settings. Findings: There was a statistically significant ethnic difference in hours for total physical activity time and hours for leisure. Whites had significantly more hours of total physical activity and hours of leisure activity per week than did other ethnic groups. According to the stepwise multiple regression analyses, being White was a statistically significant predictor of more hours of total physical activity after adjusting for confounding variables. Usual activity level and social support were significant predictors of hours of physical activity in the White group. Employment status, income level, and social support were significant predictors of hours of physical activity in the Hispanic group. Age was a significant predictor of hours of physical activity in the African group. Country of birth was a significant predictor of hours of physical activity in the Asian group.
Kathleen Leask Capitulo, DNSc, RN, FAAN, Marjorie Ramirez, MA, EdM, RN, Betina GrigoroffAponte, BS, IBCLC, and Doris Vahey, PhD, RN
Background: Bereaved parents are among the most vulnerable populations in Maternal-Child Health. However, research in perinatal bereavement has been limited to white, non Hispanic populations. Purpose: The purpose of this study was to scientifically translate a research instrument to measure perinatal grief in Spanish speaking parents and to psychometrically test the instrument to accrue evidence for reliability and validity. Methodology: The authors used translation/backtranslation, focus groups, and expert translation to develop the new Spanish Short Version of the Perinatal Grief Scale (SpSVPGS). The instrument was administered to convenience samples 50 bereaved Spanish speaking parents and a control group of 40 Spanish speaking non-bereaved parents. Findings: Content validity and reliability for the new instrument were established. In this study, most Spanish speaking parents participated in bereavement rituals, including seeing, holding, touching, naming, and having funerals, for their deceased child. The data showed a 29% decrease in the percent of parents married at the time of the loss and the time of the study. Findings may enable clinicians to better meet the bereavement needs of Spanish speaking parents experiencing perinatal losses. Analysis of demographic information, including marital status and rituals, may enable clinicians to e16
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