Research in nursing & health
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Multivariate methods are required to assess the interrelationships among multiple, concurrent symptoms. We examined the conceptual and contextual appropriateness of commonly used multivariate methods for cancer symptom cluster identification. ⋯ As a basis for new directions in symptom management, FA methods are more appropriate than HCA. Principal axis factoring or maximum likelihood factoring, the scree plot, oblique rotation, and clinical interpretation are recommended approaches to symptom cluster identification.
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Randomized Controlled Trial
Randomized controlled trial of SPIRIT: an effective approach to preparing African-American dialysis patients and families for end of life.
This randomized controlled trial tested an intervention, Sharing Patients' Illness Representations to Increase Trust (SPIRIT), designed to enhance communication regarding end-of-life care between African Americans with end-stage renal disease (ESRD) and their chosen surrogate decision makers (N = 58 dyads). We used surveys and semi-structured interviews to determine the feasibility, acceptability, and preliminary effects of SPIRIT on patient and surrogate outcomes at 1 week and 3 months post-intervention. We also evaluated patients' deaths and surrogates' end-of-life decision making to assess surrogates' perceptions of benefits and limitations of the SPIRIT while facing end-of-life decisions. We found that SPIRIT promoted communication between patients and their surrogates and was effective and well received by the participants.
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The purpose of this study was to evaluate the psychometric properties of three versions of the Perceived Stress Scale (PSS; American Sociological Association) in adults who had survived the death of a family member or significant other by suicide. Reliability and validity were examined. Exploratory factor analysis was conducted to assess dimensionality of the underlying constructs. ⋯ Two shorter versions retained good psychometric properties and demonstrated convergent and concurrent validity with measures of posttraumatic stress symptoms and mental health quality of life. Factor analysis provided further evidence of their usefulness as brief and valid measures of perceived stress in acutely bereaved adult survivors of suicide. In a sub-sample of closely related survivors, the psychometric properties of the 4-item version of the PSS were retained.
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We examined the experience of 21 women diagnosed with breast or ovarian cancer who received inconclusive BRCA1/2 genetic test results. Although these women received similar information on the technical meaning of an inconclusive result, their interpretations of personal risk for a probable, inherited cancer mutation differed. Their interpretations ranged from confidence that they probably carried an undetected gene mutation to believing that their cancer had no genetic basis. Women drew from their personal experience with genetic testing and from distinctive perceptions and beliefs in attempting to understand their test results; they variously drew upon such evidence as observations of similarities and differences within familial breast/ovarian cancer patterns to explain their ultimate conclusions as to their own genetic status.
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The purpose of this study was to develop and psychometrically test a new instrument for measuring self-management of adults with type 2 diabetes. Data were collected from 634 diabetic adults recruited from three teaching hospitals in Taiwan. Construct validity was determined by confirmatory factor analysis (CFA). ⋯ This model was further cross validated in a second sample. Cronbach's alpha coefficient of the DSMI total scale was .94. The test-retest correlations for the DSMI total scale were acceptable (r = .73, p < .01).