bluuebunny/crossref_metadata_2025 huggingface dataset:
ESTILO DE APRENDIZAJE Y DESEMPEÑO ACADÉMICO: VARIABLES DEL ENTORNO EDUCATIVO
Authors: Gonzáles Garay Jhon Harol , Turpo Josué
Published: September 2018

El objetivo del artículo es determinar la relación que existe entrelos estilos de aprendizaje y el desempeño académico en los estudiantesde la Escuela Profesional de Arquitectura de la Universidad Peruana UniónFilial Tarapoto, 2017. La metodología corresponde al diseñocorrelacional transeccional con aplicación de instrumentos validados enuna población de estudiantes de arquitectura. Entre los resultados seencontró que los estilos de aprendizaje se relacionan significativamente(p_value=0.05) con el desempeño académico en los estudiantes deArquitectura de la Universidad Peruana Unión, Filial Tarapoto, 2017, deforma similar ocurre con la dimensión estilo teórico (r = -.193*; p=.04); la dimensión estilo pragmático (r = -.259**; p= .01), con eldesempeño académico, sin embargo, el estilo reflexivo no se relacionasignificativamente (p_value>0.05), así como la dimensión estilo activono se relaciona significativamente (p_value>0.05) con el desempeñoacadémico en los estudiantes de Arquitectura de la Universidad PeruanaUnión, Filial Tarapoto, 2017, por lo tanto son dos dimensiones conrelación significativa son: estilo teórico y estilo pragmático, y dosdimensiones que no se relacionan que son: estilo reflexivo y estiloactivo. En conclusión, se encuentra que los estilos de aprendizaje serelacionan significativamente (p_value=0.05) con el desempeño académicoen los estudiantes de Arquitectura de la Universidad Peruana Unión,Filial Tarapoto, 2017.
Assessing forest fire behavior simulation using FlamMap software and remote sensing techniques in Western Black Sea Region, Turkey
Authors: YAVUZ Mehmet , SAĞLAM Bülent , KÜÇÜK Ömer , TÜFEKÇİOĞLU Aydın
Published: September 2018

Aim of study: Forest fuels are very critical for fire behavior models and hazard maps. Relationship among wind speed, fuel moisture content, slope, and fuel type directs us to predict fire behavior of a given region. For this study, we evaluated fire behavior parameters such as fireline intensity and rate of fire spread using the fuel moisture content, slope, fuel load, and wind speed for the Bayam Forest District with the help of remote sensing techniques and FlamMap software.Area of study: The study area is located in Bayam Forest District in the city of Taskopru, Kastamonu, a Western Black Sea region of Turkey.Material and Methods: In order to estimate and map forest fuel load of the study area, fuel models were developed using the parameters of the average vegetation height, 1-hr, 10-hr, and 100-hr fuel load, foliage, total fuel load, litter load and litter depth. Three basic fire descriptors (fireline intensity, rate of fire spread, and flame length) were calculated using FlamMap software with the parameters fuel load, wind speed, fuel moisture, and slope. Using the descriptors above, the historical fire data was overlaid with the fireline intensity maps to determine fire potential areas within the remote sensing and GIS framework.Main results: The results of this study showed that 20.0% of the region had low (<2 m min-1), 43.2% had moderate (2-15 m min-1), 12.0% had high (15-30 m min-1), and 24.8% had very high (>30 m min-1) rate of fire spread, respectively. The fireline intensity map showed that 60.7% of the area was in low (0-350 kW m-1), 24.9% was in moderate (350-1700 kW m-1), 1.3% was in high (1700-3500 kW m-1), and 13.0% was in very high (>3500 kW m-1) fireline intensity.Highlights: The spatial extent of fuel types was observed and three of the potential fire behavior predictors (fire intensity, rate of fire spread and flame length) were estimated using remote sensing and GIS techniques. The overlaid historical fire data showed that the most fire-prone areas are in the mixed young Anatolian black pine - Scots pine tree stands that have 40-70% canopy cover and that are in the young Anatolian black pine tree stands that have more than 70% canopy cover.
Sınıf Öğretmeni Adayları Hayat Bilgisi Derslerinin Öğretimine Yönelik Neler Düşünüyor?
Authors: ÜTKÜR Nur
Published: September 2018

Sınıf öğretmenliği programına yeni başlayan öğretmen
adaylarının Hayat Bilgisi derslerinin nasıl işlenmesini tercih ettiklerine
yönelik görüşlerinin alınması bu çalışmanın amacını oluşturmaktadır. Nitel araştırma yönteminin kullanıldığı bu çalışmada, Sınıf
Eğitimi Ana Bilim Dalı’nda 1. sınıfta öğrenim görmekte olan 38 öğretmen adayına
açık uçlu anket uygulanmıştır. Ankette yer alan sorular, öğretmen adaylarının
Sınıf Eğitimi programını neden seçtikleri, Hayat Bilgisi Öğretimi dersinde
işleneceklere ve kullanılan öğretim yöntemlerine yönelik görüşlerinin neler
olduğuyla ilişkilidir. Yapılan içerik analizi sonucunda öğretmen adaylarının
çoğunluğunun puanları bu bölüme yettiğinden, azınlığınınsa bu mesleği
istediklerinden bu bölümü seçtikleri tespit edilmiştir. Ayrıca Hayat Bilgisi
öğretimi derslerinin günlük hayattan örneklerle işlenmesini tercih ederken,
ileride işleyecekleri derslere yönelik uygulamalar yaptırılmasının kendileri
için yararlı olacağını düşünmektedirler. Ancak öğretmen adaylarından bazıları
bu derslerde tarih, coğrafya, vatandaşlık gibi ezber içeren derslerin yer
alacağını düşündüklerini, bu nedenle derslerin sıkıcı olacağını tahmin
ettiklerini belirtmektedirler. Hayat Bilgisi derslerinde kullanılabilecek
öğretim yöntemlerinden örnek olay incelemesi ve drama ile ilgili olumlu
görüşlerde bulunmuşlardır. Örnek olay incelemesiyle ilgili daha çok günlük
yaşamdan örnek vermek ve konuyla ilgili örnek bir durumu anlatmak şeklinde
görüş belirten öğretmen adayları, dramayla ilgili canlandırma, olayı yaşatmak
ve uygulamak, eğlenceli şeklinde yorumlarda bulunmuşlardır. Öğretmen adayları
bu öğretim yöntemlerinin Hayat Bilgisi derslerinde kullanılmasının yararlı
olacağını düşünmektedirler.
Öğretmen Adaylarının Bilim ve Bilim İnsanı Kavramlarına İlişkin Algılarının Metafor Analizi Aracılığıyla İncelenmesi
Authors: Özgün Bilgi Başak , Gürkan Gülşah , Kahraman Sibel
Published: September 2018

Bu çalışmanın amacı
öğretmen adaylarının “bilim” ve “bilim insanı” kavramlarına ilişkin algılarını
metaforlar aracılığıyla ortaya çıkarmaktır. Nitel araştırma yöntemlerinden olgu bilim desenine
göre tasarlanan çalışmada, içerik analizi tekniği kullanılmıştır. Veriler,  62 fen bilgisi, 45 sınıf
öğretmeni olmak üzere toplam 107 öğretmen adayının “Bilim/Bilim İnsanı …… gibidir.
Çünkü ……” ifadelerini tamamlamasıyla elde edilmiştir. Sonuçlarımıza göre, öğretmen
adayları “Bilim” kavramı için 85, “bilim insanı” kavramı için 80 geçerli metafor üretmiştir. Öğretmen
adaylarından elde edilen verilerde “bilim” kavramı için en çok “Kitap” (f=5),
“bilim insanı” kavramı için ise “Güneş” (f=5) metaforu kullanılmıştır. Elde
edilen metaforlar daha sonra ortak özellikleri ve benzerlikleri dikkate
alınarak kategorileştirilmiş ve  “bilim”
kavramı için sekiz, “bilim insanı” kavramı için altı kategori elde edilmiştir. Öğretmen adayları
“bilim” kavramını çoğunlukla “emek-çaba ve araştırmaya bağlı” (f=17) bir yapı,
“bilim insanı” kavramını ise “araştıran, çabalayan, çalışkan bir kişi” (f=31)
olarak görmektedir.
Kavramsal
kategoriler, öğretmen adaylarının cinsiyeti, sınıf düzeyleri ve bölüm türü
bakımından da farklılaşmıştır.
“Bilim” ve “bilim insanı” kavramlarına ilişkin oluşturulan metaforlar arasında
olumsuz bir metafora rastlanmamıştır.
Mudas de Mimosa caesalpiniaefolia Benth (Leguminosae: Mimosoideae) cultivadas em substratos orgânicos
Authors: Pinheiro José Israel , Oliveira Lucas De Sousa , Sousa Alfredo Mendonça de , Garcia Kaio Gráculo Vieira , Lima Luan Alves
Published: September 2018

O sucesso no cultivo de espécies florestais, como o sabiá (Mimosa caesalpiniaefolia Benth), depende, essencialmente, da utilização de mudas de boa qualidade. Nessa etapa da produção, diversos materiais possuem potencial de uso, principalmente, resíduos orgânicos, notando-se, contudo, pouca informação a respeito do potencial de utilização desses resíduos na produção de mudas. Diante do exposto, objetivou-se avaliar o desenvolvimento inicial de mudas de sabiá em função da utilização de substratos orgânicos. O experimento foi conduzido em casa de vegetação pertencente ao Departamento de Ciências do Solo da Universidade Federal do Ceará, Fortaleza, Ceará. O delineamento experimental foi inteiramente casualizado com quatro tratamentos, esterco bovino + areia (E.B), esterco caprino + areia (E.Ca), esterco de coelho + areia (E.Co), todos na proporção de 1:1, e controle a base de areia (A) com seis repetições. Aos 84 dias após a semeadura as plantas foram coletadas para a determinação das seguintes variáveis: número de folhas (NF), altura de plantas (ALT), diâmetro do caule (DC), comprimento da raiz (CR), massa seca da parte aérea (MSPA) e massa seca de raiz (MSR). Com exceção da variável CR, todas as variáveis foram influenciadas significativamente pelo uso dos substratos. O NF apresentou maiores médias quando as plantas foram cultivadas em esterco de caprino ou bovino. Em relação à ALT e DC, constatou-se comportamento semelhante ao NF, no entanto, para o DC, o esterco de coelho foi estatisticamente semelhante ao bovino e caprino. Assim, mudas de sabiá podem ser produzidas em substrato base de estercos bovino e caprino em mistura com areia na proporção de 1:1. O melhor desenvolvimento inicial de mudas de sabiá se dá com a utilização de substrato à base de esterco bovino.
Interventions to Reduce the Impact of Chronic Disease: Community-Based Arthritis Patient Education
Authors: GOEPPINGER JEAN , LORIG KATE
Published: September 2018

Systematic development and testing of the efficacy of educational interventions to improve functioning, prevent disability, and reduce the impact of chronic disease has been limited, perhaps because many chronic diseases disable, do not kill, and because they are managed largely within home, work, and community environments and not within the medical care system. Until recently, these factors contributed to a paucity of arthritis educational interventions. But since the impetus provided by the establishment of the Multipurpose Arthritis Centers Program of the NIH (1977), a number of arthritis patient education programs have been established and evaluated. This chapter summarizes findings from community-based arthritis patient education studies conducted between 1980 and 1995, critiques the methods of these studies, and provides guidance for state-of-the-art community-based intervention research aimed at reducing the individual and social impact of arthritis and other chronic diseases.
Adherence to Therapy in Tuberculosis
Authors: COHEN FELISSA L.
Published: September 2018

Tuberculosis (TB) is a leading cause of morbidity and mortality worldwide. In the United States, TB has undergone a resurgence and the appearance of multidrugresistant TB has caused new concerns. A critical part of TB treatment is adherence to the prescribed therapy for a considerable time period. Treatment “failure” is often due to nonadherence. Many factors influence adherence to therapy in TB. This chapter reviews research in the area of adherence to the TB treatment plan in the United States and worldwide. It discusses adherence as an outcome related to treatment regimens such as directly observed therapy, patient characteristics, life and family circumstances, motivation, education, incentives, and combination strategies. Themes across studies are compared and suggestions for successful future studies are identified.
Long-Term Vascular Access Devices
Authors: FULTON JANET S.
Published: September 2018

Introduced in the 1970s, long-term vascular access devices are used in both adults and children, with about 500,000 devices placed annually. This integrative review of research on dressings to minimize infectious catheter-related complications showed that current practices were adapted from knowledge derived from short-term central venous and peripheral catheters without thorough investigation. Summary and critique of recent, as well as older significant studies, provide guidance for future research. Specifically, future research should demonstrate greater confidence in outcome measures with attention to reliability of laboratory methods, diagnostic criteria, and interrater reliability. Continuing research efforts are needed to capture unique design features of various devices, qualify device performance across prolonged time, examine nuances within patient subgroups, and address underrepresented patients and settings. Confounding and interacting variables require greater attention in study design and analysis.
Interventions for Cognitive Impairment and Neurobehavioral Disturbances of Older Adults
Authors: CRONIN-STUBBS DIANE
Published: September 2018

This synthesis of the research literature includes a discussion of selected neurobehavioral disturbances that accompany impairments in cognitive functioning in older adults. A combination of computerized and manual searches was used to access interdisciplinary and nursing research reports on the care and treatment of older adults who are cognitively impaired. The results demonstrated that protocols are needed that systematically integrate and evaluate extant working knowledge and evolving research bases for proactive preventive approaches to the care of cognitively impaired older adults with neurobehavioral disturbances.
Health Promotion for Family Caregivers of Chronically Ill Elders
Authors: GIVEN BARBARA A. , GIVEN CHARLES W.
Published: September 2018

Previous research has focused almost exclusively on the burden and the negative effects of caregiving on the primary caregivers of the chronically ill. This prior research has provided a backdrop for understanding the psychological and physical challenges that caregiving incurs. Missing from past research, however, is any focus on the health promotion strategies of this caregiving population. Although some literature focuses on the psychological well-being, few articles deal with the physical health status of caregivers. Fewer yet describe the health promotion strategies that caregivers use to maintain their health.

The chapter reviews existing literature regarding health promotion activities of primary caregivers in the context of articles focused on the psychological and physical health status of caregivers. Health promotion strategies will be discussed, as will recommendations for future research in this topic area.
Schizophrenia
Authors: FOX JEANNE C. , KANE CATHERINE F.
Published: September 2018

Psychiatric nursing research has historically focused on psychosocial phenomena characteristic of personal experience or symptomatology associated with mental illness. The current climate of the mental health service system and basic science knowledge proliferation require nurse researchers to develop and evaluate interventions based on biological understanding of symptoms. This review examines psychiatric nursing and the broader psychiatric literature from 1990 to 1996 to provide a synthesis of the current research knowledge about important components of the field of schizophrenia research including causal processes, course and outcome, symptoms, treatment, relapse prevention, and consumer providers, followed by a discussion of directions for future research.
Health Care for the School-Age Child
Authors: ANN LONG KATHLEEN , WILLIAMS DAVID
Published: September 2018

The research related to health care for school-age children is reviewed. Two major categories are considered, namely, health-risk behavior and psychosocial health. Research related to the emerging issues of homelessness and AIDS is also reviewed. The research completed to date on school-age children’s health care is critiqued with an emphasis on the state of the science in nursing. Recommendations for further research are provided.
Acute Pain
Authors: GOOD MARION
Published: September 2018

The review of acute pain describes the problem of unresolved pain and its effects on the neural, autonomic, and immune systems. Conceptualizations and mechanisms of pain are reviewed as well as theories of pain management. Descriptive studies of patient and nurse factors that inhibit effective pain management are discussed, followed by studies of pharmacological and nonpharmacological interventions. Critical analysis reveals that most studies were atheoretical, and therefore, this proliferation of information lacked conceptual coherence and organization. Furthermore, the nature and extent of barriers to pain management were described, but few intervention studies have been devised, as yet, to modify the knowledge, beliefs, and attitudes of nurses and patients that are barriers to pain management. Although some of the complementary therapies have sufficient research sup port to be used in clinical pain management, the physiological mechanisms and outcomes need to be studied. It is critical at this time to design studies of interventions to improve assessment, decision making, attentive care, and patient teaching.
The Chronobiology, Chronopharmacology, and Chronotherapeutics of Pain
Authors: AUVIL-NOVAK SUSAN E.
Published: September 2018

Data for this review of chronobiology, chronopharmacology, chronotherapeutics and pain were derived from electronic searches of the medical literature (Medline) utilizing both Silver Platter and OVID search engines. Further information was obtained from personal conversations with members of the International Society for Chronobiology involved in chronopharmacology and pain research and reviews of non-Medline-referenced materials and journals such as Chronobiologia and the Annual Review of Chronopharmacology. A variety of data from proceedings were available, but was not utilized because of their nonrefereed status and the relative unavailability of such sources; however, peer-reviewed, published proceedings have been included in this review.

A total of 62 studies were identified as relevant to this review of biological rhythms and pain; of these, only 6 were conducted by nurses. Studies were broadly categorized by purpose as experimental chronobiology in humans (9), experimental chronobiology in animals (12), clinical chronobiology (25), chronopharmacology in animals (6), chronopharmacology in humans (6), and chronotherapeutic interventions (4). All statistically significant findings were reported at the p < 0.05 level.
Chronic Low Back Pain: Early Interventions
Authors: FAUCETT JULIA
Published: September 2018

Low back pain is a common and costly social problem. Many of the long term outcomes of chronic low back pain (CLBP), such as those related to occupational and social function or patient and family coping, are sensitive to nursing intervention. To identify potentially productive areas for nursing intervention research, studies from 1990 to 1998 were reviewed that investigated (a) potential early indicators that acute or subchronic low back pain would result in chronic pain and disability, (b) patient perspectives on adaptation to chronic pain, and (c) the value of interventions undertaken during the acute and subchronic phases of back pain to modify long-term outcomes. Sixteen quantitative studies were identified that prospectively investigated the natural history and outcomes of low back pain. Six qualitative studies that investigated the perspectives of patients with back pain were also identified. Ten randomized clinical trials were identified that investigated interventions undertaken during the acute or subchronic stages of back pain.

Clinical interventions that included advice to re-engage in activity, support to develop personalized goals, reinforcement for healthy gains and appropriate functional activities, and physical conditioning exercises tended to be successful in returning patients to work or limiting their self-reported disability and pain. Interventions that promoted communication at the worksite or modified the patient’s job were also successful in promoting a faster return to work. Nonetheless, this is a nascent area of research in need of improvements related to the selection of appropriate subjects and controls, the timing and duration of interventions, and the reliability with which interventions are implemented. Furthermore, patients with back pain are most likely to benefit when nursing theories about chronic pain are linked to clinical intervention research.
Primary Health Care
Authors: MCELMURRY BEVERLY J.
Published: September 2018

Primary Health Care (PHC) has been promulgated for over two decades as a global strategy for ensuring basic health care for all people. PHC is characterized by equity, accessibility, availability of resources, social participation, intersectoral community action, and cultural sensitivity. While PHC can be discussed as philosophy or a process, it is critical that PHC be understood as a community focus in health care that differs from a primary care focus on individuals. Capturing PHC components in community-based interventions in order to advance the development of a rigorous research base requires a shift in thinking about what constitutes acceptable methods and evidence for evaluating changes in health care. To this end, the authors of this review discuss perspectives and available research that inform practice within multidisciplinary teams, highlight the importance of social discourse, and review participatory evaluation issues for achieving a working relationship with communities. Particular attention is focused on education for nurses’ roles in PHC activities within implementation models fostering community mobilization and development. An action plan is suggested as a means for situating discrete research activity within a PHC framework.
Sleep Promotion in Adults
Authors: FLOYD JUDITH A.
Published: September 2018

Insomnia is among the most frequent health complaints brought to the attention of primary care providers. The prevalence estimates are highest in women, older adults, and patients with medical or psychiatric disorders. Clinical researchers have studied many barriers to sleep as well as some sleep promotion interventions for the ill and aging adult. Environmental, personal, and person-environment rhythm factors have been identified as correlates of poor sleep. All interventions studied by nurse researchers are non-pharmacological and have been classified as interventions that (a) create an environment more conducive to sleep, (b) relax the sleeper, or (c) entrain the circadian sleep-wake rhythm. This chapter summarizes results of published research on correlates of poor sleep and interventions to promote sleep. The chapter includes the relevant studies conducted by researchers in related disciplines as well as nurses’ research. The arcs© software package was used to facilitate summarization of intervention studies. It was concluded that correlates of poor sleep are well described, but theories of sleep promotion are not well explicated. Also, the research base for sleep promotion interventions for use with clinical populations other than those with chronic insomnia is sparse. Gaps in knowledge are identified and conceptual and methodological issues are discussed as the basis for future directions in sleep promotion research.
Guided Imagery Interventions for Symptom Management
Authors: ELLER LUCILLE S.
Published: September 2018

For the past several decades, papers in the nursing literature have advocated the use of cognitive interventions in clinical practice. Increasing consumer use of complementary therapies, a cost-driven health care system, and the need for evidence-based practice all lend urgency to the validation of the efficacy of these interventions. This review focuses specifically on guided imagery intervention studies identified in the nursing, medical and psychological literature published between 1966 and 1998. Included were 46 studies of the use of guided imagery for management of psychological and physiological symptoms. There is preliminary evidence for the effectiveness of guided imagery in the management of stress, anxiety and depression, and for the reduction of blood pressure, pain and the side effects of chemotherapy. Overall, results of this review demonstrated a need for systematic, well-designed studies, which explore several unanswered questions regarding the use of guided imagery. These include the effects of different imagery language, symptoms for which guided imagery is effective, appropriate and sensitive outcome measures, method of delivery of the intervention and optimum dose and duration of the intervention, and individual factors that influence its effectiveness.
Interventions for Children with Diabetes and Their Families
Authors: GREY MARGARET
Published: September 2018

The purpose of this review is to examine the research literature on interventions for children with type 1 diabetes and their families, with a specific focus on three types of intervention (educational and psychosocial/behavioral interventions that focus on individuals with diabetes and family interventions for families, usually parents, of individuals with diabetes). The aim of the review is to determine what interventions produce what outcomes in what populations of children and families. The review includes articles that met the following criteria: (a) empirical study reporting the impact of an intervention on such outcomes as knowledge, behavior, self-care, and metabolic control; (b) children with type 1 diabetes and/or their families as primary subjects; (c) publication between 1980 and January 1, 1999; and (d) publication in English. A total of 41 published papers were included. On the basis of this review, conclusions are as follows: (a) Educational interventions are useful in improving diabetes knowledge but not consistently helpful in improving metabolic control; (b) psychosocial interventions, especially coping skills training and peer support, assist primarily adolescents to improve adjustment and sometimes metabolic control; and (c) family interventions may be helpful in reducing parent-child conflict about diabetes management and care.
Heart Failure Management: Optimal Health Care Delivery Programs
Authors: MOSER DEBRA K.
Published: September 2018

Heart failure is the single most costly health care expenditure in the United States, The major proportion of these costs is attributable to rehospitalizations, and by many estimates the majority of rehospitalizations might be preventable with better health care delivery. The past 5 years have seen an explosion in the number of heart failure disease management programs put in place across the country to try to decrease the economic burden of heart failure and improve patient outcomes. Yet few of these are based on programs tested by researchers, let alone tested in randomized, controlled trials. This chapter summarizes findings from studies of heart failure disease management programs from 1980 to the present, critiques those studies, and offers suggestions for future research in this area.
Women and Stress
Authors: CAHILL CHERYL A.
Published: September 2018

This review focused on published research reports that explored the association between stress and women’s health and illness. Because of the vastness of the literature, the review was limited to three conceptual areas. The first included those studying the association between stress and illness. Most were correlational in design, thus lacking the power to support assertions of a cause-and-effect relationship. The second focused on studies of the psyehophysiology of stress. These studies provide nurse scientists and clinicians with insights into the underlying pathology of stress. When paired with behavioral measures, these studies provide a window into brain mechanisms involved in mind/body interactions. The third conceptual area included those studies of stress reduction therapies to influence health and illness. These studies have yielded a mighty arsenal of interventions that may be used to reduce distress.
What We Know and How We Know It: Contributions from Nursing to Women’s Health Research and Scholarship
Authors: TAYLOR DIANA , WOODS NANCY
Published: September 2018

In this first chapter, we trace the historical roots of nursing research and scholarship focused on protecting and promoting women’s health. Beginning with Florence Nightingale, modern nursing’s first researcher, who focused on the health impact of women’s daily lives through her detailed observations of human behavior. More recently, nursing’s contributions to women’s health over the past 30 years have redefined women’s health, proposed new frameworks for understanding women’s health; provided reviews of the women’s health literature across disciplines; developed communities of nurse scholars and researchers focused on new areas of women’s health research; generated and expanded the knowledge base for women’s health practice and education; promoted a global view of women’s health; and proposed new models for women’s health care delivery. Clearly, a community of nursing scholars, developed over the past 25 years, has contributed to advancing women’s health knowledge and improving the health and well-being of women. Without the benefit of a crystal ball, we suggest that nursing will continue to provide leadership in the conduct and the application of research to improve women’s health and women’s lives.
Interventions for Family Members Caring for an Elder with Dementia
Authors: ACTON GAYLE J. , WINTER MARY A.
Published: September 2018

This chapter reviews 73 published and unpublished research reports of interventions for family members caring for an elder with dementia by nurse researchers and researchers from other disciplines. Reports were identified through searches of MEDLINE, CINAHL, Social Science Index, PsycINFO, ERIC, Social Work Abstracts, American Association of Retired Persons database, CRISP index of the National Institutes of Health, Cochrane Center database, and Dissertation Abstracts using the following search terms: care giver, care giving, dementia, Alzheimer’s, intervention study, evaluation study, experimental, and quasi-experimental design. Additional keywords were used to narrow or expand the search as necessary. All nursing research was included in the review and nonnursing research was included if published between 1991 and 2001. Studies were included if they used a design that included a treatment and control group or a one-group, pretest-posttest design (ex post facto designs were included if they used a comparison group). Key findings show that approximately 32% of the study outcomes (e.g., burden, depression, knowledge) were changed after intervention in the desired direction. In addition, several problematic issues were identified including small, diverse samples; lack of intervention specificity; diversity in the length, duration, and intensity of the intervention strategies; and problematic outcome measures.
End-of-Life Care for Older Adults in ICUs
Authors: BAGGS JUDITH G.
Published: September 2018

This review was undertaken to present and critique the most recent (1990-2000) empirical evidence about end-of-life care for older adult patients in ICUs, their families, and care providers. The studies (including descriptive, correlational, longitudinal, and intervention) were found using a combination of these terms: (a) intensive care (units) or critical care (units), and (b) critical illness, critically ill patients, terminally ill, terminal care, life support care, or palliative care. The computerized databases searched were CINAHL and MEDLINE. Only published studies of persons 44 years of age or older, written in English, and conducted in the U.S. or Canada were included. Research was not limited to studies conducted by or written by nurses. Excluded were articles focused on physiology, for example, studies of treatment for specific conditions, and articles focused on predictors of ICU outcomes.

Findings and Implications for Research

There is little research specifically focused on end-of-life care of older adults in ICUs. Most research has been retrospective, and most has involved either providers or patients and families but not both.

Research is needed in many areas. The mechanism by which age affects choice of care needs further exploration. The experience of patients, families, and providers and how those experiences change with interventions needs investigation. The influence of the ICU culture, variation in decisions made and reasons for that variation, the decision-making process, and variations in care, all require further attention. Four domains were identified for research needed to improve care for older adults at the end of life in intensive care: symptom relief, communication improvement, psychological support, and relationship improvement. No one has assessed whether the ICU is a good place for transition to palliation to occur, or whether it would be better to transfer patients to another type of unit.
Home Health Services Research
Authors: MADIGAN ELIZABETH A. , TULLAI-MCGUINNESS SUSAN , FELBER NEFF DONNA
Published: September 2018

This chapter reviews 69 published research reports of home health care from a health services perspective by nurse researchers and researchers from other disciplines. Reports were identified through searches of the National Library of Medicine (MEDLINE), and the Cumulative Index to Nursing and Allied Health Literature and Social Sciences Citation Index using the following search terms: home health care, health services research, and elders. Within the major areas identified, the following additional terms were specified: resource use and outcomes. Reports were included if published between 1995 and 2001, used samples age 65 and older, performed in the U.S., and published in English. Studies of all types were included. The key findings follow: (a) Most studies were atheoretical. If a theoretical model was used, it was most often the Andersen Behavioral Model, (b) Few conclusions can be drawn about resource use—increasing age and higher severity of health related problems are associated with higher numbers of home visits. The variety of measures of resource use and the study approaches (large national data sets versus single or several agency samples) limits the ability to draw conclusions on resource use. (c) There is a growing body of evidence on rehospitalization of home health care patients which indicates rehospitalization is prevalent but largely not predictable, (d) Patient outcomes research is inconclusive at this point, primarily because there are few studies that examine patient outcomes using a consistent set of measures. The main recommendations are: to study rehospitalization using a more profile-based approach to determine visit patterns that may be effective, to further specify the kinds of outcomes that may be achieved as a result of home health care and which patients might be expected to achieve positive outcomes, and to examine the integration of home health care with the broader community-based services.
Telehealth Interventions to Improve Clinical Nursing of Elders
Authors: JONES JOSETTE F. , BRENNAN PATRICIA F.
Published: September 2018

This chapter reviews reports of research conducted worldwide from 1966 to January 2001 on telehealth interventions in clinical nursing for elders. Reports were identified through a systematic search of MEDLINE, CINAHL, PsychInfo, ERIC, and ACM using the search terms Telemedicine or Health Information Networks, Nursing, and Research, and were restricted to those published in English. Reports of research using interactive computer technology to assess or intervene with nursing problems commonly observed in persons age 65 and older were sought. Only published reports presenting the findings of an exploratory or experimental study and exploring the association between one intervention variable and technology were included. The search resulted in 18 research reports describing eight research projects. Due to the preponderance of demonstrations and feasibility reports, the dearth of experimental investigations, and the heterogeneous nature of the few studies identified, statistical summarization was not attempted. Telehealth interventions have the potential to improve the clinical nursing care of elders because they provide alternative, equivalent approaches to assess key indicators of the physical and psychological state of elders; are acceptable to nurses, elders, and family caregivers; and may prove less costly than face-to-face interventions. Telehealth approaches provide not only acceptable substitutes for discrete nursing actions but also can serve as a context within which a large range of professional gerontological nursing services can be delivered in a manner that is timely and convenient for elders.
Genetics and Gerontological Nursing: A Need to Stimulate Research
Authors: FRAZIER LORRAINE , OSTWALD SHARON K.
Published: September 2018

The purpose of this chapter is to discuss how genetics will affect gerontological nursing. The chapter will answer two questions: (1) Which aspects of genetics will be most relevant to future gerontological nursing practice? and (2) What will be the impact of genetics on the future of gerontological nursing education and research? MEDLINE was searched for relevant articles from 1995 to 2001 using the key words aging, genetics, geriatrics, nursing education, research, and gerontology. CRISP was searched using the thesaurus terms education/planning, genetics, health education, model design/development, psychological model, pubic health curriculum, behavioral/social science research, and research nursing/genetics. A total of 101 nursing and nonnursing articles were reviewed. Research reports were selected if they focused on issues related to gerontological nursing. Articles were reviewed that had application to genetic nursing, complex diseases, and genetics.

The evolution of the science of genetics will revolutionize gerontological nursing and affect future nursing education and research as the concepts of genetic science and the technology they generate are translated into everyday clinical practice. Genetic discoveries in common complex diseases will affect care provided by gerontological nurses in the 21st century. Gerontological nurses must move quickly to recognize this genetic paradigm shift and to incorporate genetics issues into their nursing practice.
Enhancing Nursing Research With Children and Families Using a Developmental Science Perspective
Authors: MILES MARGARET S. , HOLDITCH-DAVIS DIANE
Published: September 2018

Nursing scholarship on children and their families has increased rapidly over the past decades. This research focuses on infants, children, and adolescents and their families facing acute or chronic illness, as well as on promoting health and preventing disease in children. While the amount and scope of research in pediatric nursing has increased, the methods and theories used are diverse and are often not based on the most recent science in the broader fields of developmental research. Developmental science, which evolved over the past two decades into a new interdisciplinary framework for the study of human development, involves an integrated holistic, developmental, and systems-oriented perspective. According to this view, the individual functions and develops through dynamic and complex processes involving the integration of many systems within the individual, including mental, biological, and behavioral systems. In addition, individuals function and develop in a continuously ongoing, reciprocal process of interaction with their environment and, as such, have an influence on that environment. These nonlinear, dynamic processes demand complex conceptualizations and research designs if one is to truly understand human development, including health and illness. Key aspects of developmental science important in conceptualization, design, measurement, and data analysis are identified. By providing a framework for critiquing research and presenting recommendations for future research based on developmental science, we hope to move nursing research with children forward toward more developmentally sound knowledge of nursing practice.
Symptom Experiences of Children and Adolescents With Cancer
Authors: DOCHERTY SHARRON L.
Published: September 2018

This paper examines nursing research focused on the symptom experiences of children and adolescents with cancer, and the extent to which the perspective and methods of developmental science have been used in this research. CINALH, MEDLINE, and PSYCHLIT were searched for publications between 1990 and 2002. The researcher or research team had to include a nurse or developmentally oriented researchers from other disciplines. Studies focused exclusively on pain were excluded because of recent published reviews. While nurse researchers have contributed influential knowledge related to symptom experiences and symptom distress in children and adolescents with cancer, this research is still in a formative but exciting stage. Two nurse researchers and their teams laid the foundation for this research through their individual studies and collaborative multisite studies.

In general, children and adolescents from 10 through 18 years of age were primarily studied; few studies focused on preschool children. Given the fact that these are rare populations, sample sizes were generally small, limiting power and generalizability. Gender, ethnicity, and socioeconomic status were rarely considered in analyses. Most studies used cross-sectional designs, although several included short-term longitudinal or repeated measure designs. To date, longitudinal designs focused on long-term outcomes have not been conducted. There were only a few qualitative studies. There was limited use of conceptual models or theories, and inadequate attention was paid to broader ecological perspectives in the children’s lives. Studies included a focus on global symptoms and on individual symptoms, particularly pain and fatigue. Few focused on nausea and vomiting. Operationalization of symptom distress generally involved adapting instruments designed for adults.

A more explicit employment of a developmental science perspective in future studies would call for more longitudinal designs that conceptualize the symptom experience from the perspective of the child and that view their responses as complex and multidimensional in nature. This would necessitate measuring clusters of symptoms at multiple levels (e.g., emotional, behavioral, and biophysiological) using developmental data collection methods. Furthermore, attention needs to be paid in conceptualizing studies to ecological factors related to families, social networks, communities, and ethnicity, as well as to the ecology of the health care system, which likely influences the symptom experience of children.
Care of Preterm Infants: Programs of Research and Their Relationship to Developmental Science
Authors: HOLDITCH-DAVIS DIANE , BLACK BETH P.
Published: September 2018

The purpose of this review was to examine the topics covered in current programs of nursing research on the care of the preterm infant and to determine the extent to which this research is informed by developmental science. A researcher was considered to have a current program of research if he or she had at least five publications published since 1990 and was the first author on at least three of them. The infants in a study could be any age from birth throughout childhood; studies focusing on parenting, nursing, or other populations of infants were not included.

Seventeen nurse researchers had current programs of research in this area. These programs had four themes. Those of Becker, Evans, Pridham, Shiao, and Zahr focused on infant responses to the neonatal intensive care unit (NICU) environment and treatments. Franck, Johnston, and Stevens focused on pain management. Harrison, Ludington-Hoe, and White-Traut’s research focused on infant stimulation. Holditch-Davis, McCain, McGrath, Medoff-Cooper, Schraeder, and Youngblut studied infant behavior and development.

These research programs had many strengths, including strong interdisciplinary focus and clinical relevance. However, additional emphasis is needed on the care of the critically ill infant. Also, despite the fact that the preterm infant’s neurological system develops rapidly over the first year, only three of these researchers used a developmental science perspective. Only research on infant behavior and development focused on the developmental changes that the infants were experiencing. Most of the studies were longitudinal, but many did not use statistics appropriate for identifying stability and change over time. The response of individual infants and the broader ecological context as evidenced by factors such as gender, ethnic group, culture, and intergenerational effects were rarely examined. Thus research on the care of preterm infants could be expanded if the developmental science perspective formed the basis of more studies.
Parents of Children With Chronic Health Problems: Programs of Nursing Research and Their Relationship to Developmental Science
Authors: SHANDOR MILES MARGARET
Published: September 2018

This review identified nurse researchers and research teams that have current programs of research focused on parents and parenting of children with chronic health problems. Researchers were included if they had at least five publications since 1990, with at least three of these articles first-authored. These programs of research were critiqued from a developmental science perspective. Multiple methods were used for the search, including examination of previous review articles, hand search of journals, online computer searches, and review of the curriculum vitae of authors. Seven programs of research were identified. Two programs of research focused on childhood cancer—Ida M. Martinson et al. and Marsha H. Cohen. Three programs of research used a noncategorical approach encompassing a variety of childhood chronic conditions—Katherine A. Knafl and Janet A. Deatrick, Sharon O. Burke, and Ann Garwick. One program focused primarily on parents of children with Down syndrome and disabilities—Marsha Van Riper—and another on parents of infants with a variety of chronic health problems—Margaret S. Miles and Diane Holditch-Davis. Diverse theories and conceptual frameworks were used, and most had some focus on ecological systems that might affect parents and parenting. Many used a family perspective and included fathers. Still broader aspects of the family and community ecology and the health care were not generally included. Few examined the bidirectionality of the relationship between the child and aspects of the child’s illness and parental responses. There was variability in the extent to which ethnicity and socioeconomic status were considered. Studies provide important insight into the responses of parents and their parenting of children with chronic health problems. The studies provide a sound base for continuing to build a developmentally sensitive body of knowledge related to parents and parenting of the child with chronic health problems.
Introduction: Eliminating Health Disparities Among Racial and Ethnic Minorities in the United States
Authors: VILLARRUEL ANTONIA M.
Published: September 2018

Numerous policy, research, and practice recommendations have been developed to address the persistent disparities among racial and ethnic groups in the United States. Although nurse researchers have made significant contributions in addressing health disparities, there are significant gaps that remain to be addressed. Racial and ethnic minority nurses and nurse researchers have played a significant role in addressing health disparities. The individual and collective contributions of this group of nurses in addressing health disparities is included in this Introduction. Recommendations from chapters presented in this volume of the Annual Review of Nursing Research are highlighted.