Deborah A Chyun

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Background: Individuals with cancer are surviving long term, categorizing cancer asa a chronic condition, and with it, numerous healthcare challenges. Symptoms, in particular, can be burdensome and occur from prediagnosis through many years after treatment. Symptom severity is inversely associated with functional status and quality of life. Objective: Management of these millions of survivors of cancer in a stressed healthcare system necessitates effective self-care strategies. The purpose of this integrative review is to evaluate intervention studies led by nurse principal investigators for self-care management in patients with cancer. Methods: PubMed, CINAHL (Cumulative Index to Nursing and Allied health Literature), and the Cochrane Database were searched from January 2000 through August 2012. Search terms included "symptom management and cancer," "self-management and cancer," and "self-care and cancer." All articles for consideration included intervention studies with a nurse as the primary principal investigator. Results: Forty-six articles were included yielding 3 intervention areas of educational and/or counseling sessions, exercise, and complementary and alternative therapies. Outcomes were predominately symptom focused and often included functional status and quality of life. Few studies had objective measures. Overarching themes were mitigation, but not prevention or elimination of symptoms, and improved quality of life related to functional status. No one intervention was superior to another for any given outcome. Conclusions: Current interventions that direct patients in self-care management of symptoms and associated challenges with cancer/survivorship are helpful, but incomplete. No one intervention can be recommended over another. Implications for Practice: Guiding patients with cancer in self-care management is important for overall functional status and quality of life. Further investigation and tailored interventions are warranted.

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PubMed PMID: 25692736

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Background: Hypertension is a major cause of morbidity and mortality worldwide. Medication compliance is a challenge for patients and health professionals. The aim of this work was to compare the degree of antihypertensive medication compliance between Brazilian men and women.Methods: From March to May 2009, we conducted a non-experimental, comparative study, which analysed a sample of 80 patients diagnosed with HTN who were undergoing medical treatment and had been admitted to a hospital in the state of São Paulo.Results: Most patients in the sample were women (66.2%), white (81.2%), married (55%), and with a lower educational level (80%). Their mean age was 62 years (SD= 14.1). Approximately forty-nine percent (49.1%) of the women and thirty-seven percent (37%) of the men from the sample complied with the treatment (p=0.307), however differences were observed in the individual compliance-related behaviours.Conclusions: Although this study did not show a statistically significant association between genders in relation to medication compliance, gender differences in compliance-related behaviours deserves attention. Therefore, we suggest that additional studies focusing on gender-difference be conducted so that individualized interventions can be developed.

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Background: Nursing faculty shortages threaten a country's ability to produce the amount of nurses necessary to sustain the delivery of healthcare services. Programs that "fast track" graduate education options for registered nurses are one solution to the problem. Objectives: To 1) evaluate admission criteria into PhD programs for direct entry from a bachelor's degree; 2) ascertain bachelors and masters degree nursing students' perspectives on pursuing a BSN to PhD course of study; 3) clarify factors that influence students' decision-making processes behind pursuing a PhD and identify characteristics of those who would be likely recruits for PhD study; 4) to test the survey questions to develop an instrument for future use. Design: A cross-sectional pilot study. Setting: A nursing program at a large urban university in the United States of America with an enrollment of over 1400 students. Participants: Currently enrolled bachelor's, master's, and doctor of nursing practice students. Methods: Students were sampled via a 10-question (including one open-ended question) electronic mail survey that included 1385 eligible subjects. Results: Among the 606 respondents (57% response rate), 63% were between ages 18 and 30 and 87% indicated that full tuition funding with a living stipend would make them more interested in pursuing a PhD. Current program track was a significant predictor of course of study and area of interest (p = .029). Analysis of the 427 respondents to the open-ended question revealed themes around "time" and "money" as the main barriers to study. The desire to gain clinical experience prior to PhD study was the third theme and an unanticipated finding. Conclusions: The questionnaire offered some predictive ability for gauging intent to study for a PhD among bachelor's and graduate degree prepared nurses. The results do offer some suggestions for nursing workforce development to help address faculty shortages.

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Purpose The purpose of this secondary analysis was to determine changes in physical inactivity from baseline to 5 years and to identify factors associated with and predictive of physical inactivity among individuals with type 2 diabetes enrolled in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study. DIAD was a prospective randomized screening trial that assessed the prevalence of silent ischemia in asymptomatic patients with type 2 diabetes. Subjects were recruited from diabetes and primary care practices at 14 centers throughout the United States and Canada. This is a secondary data analysis of the physical activity data (type and hours/week) collected. No intervention was conducted. In all subjects, physical inactivity rose from 24% at baseline to 33% at 5 years (S = 28.93; P

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Over the past decade, diabetes self-management (DSM) interventions have become increasingly heterogeneous to address the needs of diverse populations. The purpose of this integrative review is to summarize the state of the science regarding DSM interventions led by nurse principal investigators. The Preferred Reporting Items of Systematic Reviews and Meta-Analyses framework informed identification, selection, and appraisal of the literature. A total of 44 national and international studies (RCTs [randomized controlled trial] and quasi-experimental studies) were identified for inclusion. Across national studies, diverse ethnic groups (Latinos, African Americans, Asians, and Native Americans) were most frequently sampled (67%). Review findings identified (a) DSM intervention typologies (primary DSM intervention, DSM reinforcement intervention, and primary DSM intervention plus reinforcement intervention) and selection of blended or bundled intervention components; (b) DSM intervention translation to community-based, electronic, and home settings; and (c) DSM intervention delivery (interventionists, dosages, and fidelity).

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According to rigorous guidelines of instrument development, a 17-item chronic carriers of hepatitis B virus-related stigma scale (HBV-SS) in college students, including 4 domains (labeling, stereotype, separating, discrimination), was developed with data from 717 college students in China. Cronbach's alpha coefficient of HBV-SS was .85. Four common factors were extracted in accordance with the conceptual model. Students with HBsAg positive/ever-positive (vs. negative), with HBsAg ever-positive (vs. never positive/did not know), and students who had any family member, friend, or acquaintance as a chronic carrier of HBV (vs. had not/did not know) had significantly lower scores. Research has shown that the scale is reliable, valid, and sensitive and is recommended for application of HBV-SS to assist public health practice.

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