Publications

Abstract

The purpose of this focus group intervention was to characterize the health beliefs, self-care practices, diabetes education needs, weight-loss issues, and facilitators and barriers to diabetes health care in black women with non-insulin-dependent diabetes. Major themes that emerged from the focus group were motivation to prevent complications, unrealistic weight goals set by providers, multiple barriers to diet and exercise, and a dual role of family as supporter and deterrent to diabetes management, especially related to diet. These findings suggest that culturally sensitive and appropriate patient educational programs must be provided for minority groups such as black women who have higher rates of diabetes-related complications.

Abstract

Objectives: To assess the effectiveness of an intervention for providing information and support to HIV-positive donors on changes in their sexual behavior, and to assess which donor characteristics are predictive of behavior change. Design: Subjects were randomly assigned to a structured intervention or community referral group. Follow-up assessments were conducted every 6 months. Setting: New York City, New York, USA. Participants: A cohort of 271 HIV-infected persons who donated blood to the New York Blood Center. intervention: Donors randomized to the structured intervention program met individually with a nurse for counseling and were offered a six-session support group. The program was designed to provide information, encourage safer sexual behavior and provide support. Main outcome measures: Sexual behavior, psychological distress and psychological help seeking, and immune function. Results: In both groups there was a large decrease over time in reports of unsafe sexual activity. However, more than 30% of participants in both groups reported unsafe sexual activity at the 1-year follow-up visit. Donors randomized to the structured intervention program did not report significantly more behavior change at the 1-year follow-up. Conclusions: Better programs to promote behavior change in seropositive individuals are needed.

Abstract

THE DIABETES RESEARCH and Training Center at the Albert Einstein College of Medicine, in collaboration with Yale University School of Nursing, initiated a project to develop and implement a concentration of study at the Master's level within the field of diabetes. The concentration has resulted in involvement of advanced practice nurses in management and care of individuals with diabetes. In the article, an epidemiological perspective in diabetes care is given, along with information on how the program developed and evolved over the past 5 years. Program graduates have become certified diabetes educators and completed a Master's thesis in the area of diabetes care, resulting in practice-oriented publications.

Abstract

Research findings have changed reproductive decisions for HIV-infected women in their childbearing years. A variety of studies in the United States place the risk of vertical transmission (from mother to fetus) at between thirteen and thirty percent. Recent results of the AIDS Clinical Trial Group (ACTG) 076 protocol have found that zidovudine (ZDV; AZT) had a significant inhibitory affect on HIV transmission from mother to fetus. The Centers for Disease Control and Prevention (CDC) recommends that all women, especially those who are pregnant, be given the opportunity to learn of their HIV infection status through voluntary HIV testing and counseling. This article briefly reviews these issues and other factors that HIV-infected women may consider when making reproductive decisions and HIV-related treatment choices once pregnancy is underway.

Abstract

This article examines issues of implementing nursing information computer systems in 17 hospitals in New Jersey and the initial effects of such systems as perceived by users. Unlike previous studies that examined the effects of one system in one hospital, this study examines the effects of several major systems in a variety of settings. Many of the hospitals experienced major delays or other problems with implementation; the hospitals in which timely implementation occurred were the ones that had purchased a commercially available stand-alone nursing system and did not try to develop interfaces or do extensive development. While these hospitals did meet with difficulties and needed some software customization, the problems were not so severe as to impede timely implementation. On the other hand, most of the hospitals that had major delays had planned more ambitious projects. These hospitals either required development work with vendors or were implementing a nursing information system while simultaneously putting in place a hospital system. Initial staff impressions of the effects of the system were positive; nursing department staffs reported that they liked the nursing systems. They said that documentation was better (more readable, complete, and timely) and they also believed that care was improved because the computer prompted nurses on what to look for and what to do. Support for these systems from hospital administration, outside of nursing, was cautious and based primarily on cost/benefit results.

Abstract

Facilitating family visits in critical care settings is a challenging nursing responsibility. Before family members are in a position to be supportive of patients, they must deal with stressful aspects of the ICU environment. A model of the stages in family visits derived from a clinical field study is described. This model provides a framework for assessment and intervention strategies to facilitate patient-family contact in critical care.